Plateau Valley Hospital District

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PLATEAU VALLEY HOSPITAL DISTRICT

Doing business as

Plateau Valley Medical Clinic

Practice address

58128 Highway 330
Collbran, CO 81624-9502

Phone

(970) 487-3565

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Jessie Clark

Title

Administrator

Phone

(970) 487-3565

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Plateau Valley Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Beth Lynn Hedstrom, AGACNP-BC FNP-BC APN

  • Family Nurse Practitioner
  • Collbran, CO
  • NPI 1306407168
  Medicare reassignment Care Compare group NPD
• Deborah Nicole Borrego, RN, FNP-BC, ACNPC-AG

  • Primary Care Nurse Practitioner
  • Collbran, CO
  • NPI 1841631975
  Medicare reassignment Care Compare group
• Erika Woodyard, MD

  • Family Medicine Physician
  • Collbran, CO
  • NPI 1114075587
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654560000000",
    "number": "1609990928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58128 HIGHWAY 330",
            "city": "COLLBRAN",
            "state": "CO",
            "postal_code": "816249502",
            "telephone_number": "970-487-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58128 HIGHWAY 330",
            "city": "COLLBRAN",
            "state": "CO",
            "postal_code": "816249502",
            "telephone_number": "970-487-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATEAU VALLEY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "970-487-3565"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04703047",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "PLR3408",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04703047",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plateau Valley Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Plateau Valley Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samantha Danks, PMHNP-BC
• Beth Lynn Hedstrom, AGACNP-BC FNP-BC APN
• Juniper West Counseling, Inc.
• Paige Michal Marvin
• Monument Physical Therapy LLC
• Plateau Valley Skchool District 50
• Scott E Rollins, MD
• Zacharri William Trujillo, CAREGIVER,QMAP
• Lynda Walters, M.D.
• Vance L. Wilson, LCSW

• Family Medicine Physician in Collbran, CO
• Providers in Collbran, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.