NPIMap

Organization Active NPI

The Memorial Hospital

  • Rural Health Clinic/Center
  • Craig, CO
National Provider Identifier
1609443167
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
THE MEMORIAL HOSPITAL
Practice address
2020 W Victory Way
Craig, CO 81625-3440
Phone
(970) 826-8300
NPI assigned
Jun 4, 2021
Organization subpart
Yes
Parent organization
THE MEMORIAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Authorized official

Name
Annalia Bailey
Title
Provider Relation Coordinator
Phone
(970) 824-9411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

2020 W Victory Way
Craig, CO 81625-3440

Mailing address

750 Hospital Loop
Craig, CO 81625-8750
Phone (970) 824-9411

Other names 1

  • Memorial Regional Health Rapid Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180322000753 CO Part A Provider - Rural Health Clinic 1254231533 1 other NPI on this enrollment
Practice locations: Craig, CO

Rural health clinic certification: CCN 063415

Legal name
THE MEMORIAL HOSPITAL
Doing business as
MEMORIAL REGIONAL HEALTH
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 4, 2018
Last certification
Apr 1, 2021
Ownership / control type
Non-profit – church related
Organization structure
GovernmentNon-profit
Enrollment address
2020 W Victory Way
Craig, CO 81625-3440
Related CCNs
061314

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2142038Memorial Regional Health Rapid Care Clinic2020 W Victory Way, Craig, CO 81625Certificate of waiverJan 29, 2027

National Provider Directory

National Provider Directory
Tax ID family
Memorial Hospital10 organizations share this tax ID, including this one
Part of
Memorial Hospital

Other organizations with this tax ID 9

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Denise K Arola Individual Corporate DirectorBoard of Trustees Chairman Jan 1, 2020 20%
County of Moffat Organization, Craig, CO 5% Or Greater Direct Ownership Interest Jan 1, 1966 100%
Kelly Hepworth Individual Corporate DirectorBoard of Trustees Member Jan 1, 2017 20%
Amy Updike Individual Corporate DirectorBoard Secretary/Treasurer Jan 1, 2022 20%
Allan Reishus Individual Corporate DirectorBoard Vice Chairman May 1, 2021 20%
Jennifer Riley Individual Operational/Managerial ControlCeo Apr 12, 2022 20%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710892800000",
    "number": "1609443167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 HOSPITAL LOOP",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816258750",
            "telephone_number": "970-824-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W VICTORY WAY",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816253440",
            "telephone_number": "970-826-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE MEMORIAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE MEMORIAL HOSPITAL",
        "enumeration_date": "2021-06-04",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "ANNALIA",
        "authorized_official_title_or_position": "PROVIDER RELATION COORDINATOR",
        "authorized_official_telephone_number": "970-824-9411"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Regional Health Rapid Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Craig, CO

Sources for this page

Verify at the official NPI Registry.