NPIMap

Organization Active NPI

Valley-Wide Health Systems, Inc

Doing business as Convenient Care Community Clinic

  • Federally Qualified Health Center (FQHC)
  • Alamosa, CO
National Provider Identifier
1568627941
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
VALLEY-WIDE HEALTH SYSTEMS, INC
Doing business as
Convenient Care Community Clinic
Practice address
1131 Main St
Alamosa, CO 81101-2446
Phone
(719) 589-5161
Fax
(719) 589-5722
NPI assigned
Jul 24, 2008
Last updated
May 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jania Arnoldi
Title
President/Ceo
Phone
(719) 589-5161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1131 Main St
Alamosa, CO 81101-2446

Mailing address

128 Market St
Alamosa, CO 81101-2290
Phone (719) 589-5161

Other identifiers 1

IdentifierTypeStateIssuer
53881788MedicaidCO

Other names 1

  • Convenient Care Community Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081201000665 CO Part A Provider - Federally Qualified Health Center (FQHC) 5991609067 Practice locations: Alamosa, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1568627941. Details of each certification follow.

Federally qualified health center certification: CCN 061902

Legal name
VALLEY-WIDE HEALTH SYSTEMS, INC.
Doing business as
CONVENIENT CARE COMMUNITY CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 10, 2009
Last certification
Jan 10, 2009
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Apr 15, 1976 in CO
Enrollment address
1131 Main St
Alamosa, CO 81101-2446

National Provider Directory

National Provider Directory
Tax ID family
Valley-Wide Health Systems Inc34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Javier Martinez Individual Corporate OfficerCfo Mar 19, 2019
W-2 Managing EmployeeCfo Mar 19, 2019
Alondra Maldonado Individual Corporate OfficerBoard Member Vice Chair Mar 19, 2019
Corporate Director Mar 19, 2019
Jania Arnoldi Individual Corporate DirectorCeo/President Mar 15, 2019
W-2 Managing EmployeeCeo/President Mar 15, 2019
Mattew Martinez Individual Corporate OfficerBoard Member Treasurer Mar 19, 2019
Corporate Director Mar 19, 2019
Frances Valdez Individual Corporate OfficerChair Aug 31, 2011
Corporate Director Aug 31, 2011

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Valley-Wide Health Systems, Inc.Canon City, CO, CCN 061019 Federally qualified health center Other Aug 17, 2020

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1568627941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 MARKET ST",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012290",
            "telephone_number": "719-589-5161",
            "fax_number": "719-589-5722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 MAIN ST",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012446",
            "telephone_number": "719-589-5161",
            "fax_number": "719-589-5722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY-WIDE HEALTH SYSTEMS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-24",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "ARNOLDI",
        "authorized_official_first_name": "JANIA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "719-589-5161"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53881788",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Convenient Care Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Convenient Care Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alamosa, CO

Sources for this page

Verify at the official NPI Registry.