NPIMap

Organization Active NPI

Arkansas Valley Regional Medical Center

Doing business as AVRMC Physicians Clinic

  • General Practice Physician
  • La Junta, CO
National Provider Identifier
1649449075
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
ARKANSAS VALLEY REGIONAL MEDICAL CENTER
Doing business as
AVRMC Physicians Clinic
Arkansas Valley Regional Medical Center Physicians Clinic
Practice address
1100 Carson
La Junta, CO 81050-2751
Phone
(719) 383-6390
Fax
(719) 383-5140
NPI assigned
Feb 29, 2008
Last updated
Feb 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Authorized official

Name
Aaron Brent Crowell
Title
Physician Clinic Director
Phone
(719) 383-6390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

1100 Carson
La Junta, CO 81050-2751

Mailing address

1100 Carson
La Junta, CO 81050-2751
Phone (719) 383-6390

Other identifiers 4

IdentifierTypeStateIssuer
AR240008OtherCOBLUE CROSS
24982571MedicaidCO
CJ5303OtherCORAILROAD MEDICARE
04102042MedicaidCO

Other names 2

  • AVRMC Physicians Clinic Doing business as
  • Arkansas Valley Regional Medical Center Physicians Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000685 CO Part B Supplier - Clinic/Group Practice 9436062833 Receives reassigned benefits from 35 practitioners
1 other NPI on this enrollment
Practice locations: La Junta, CO; Rocky Ford, CO

Other NPIs with the same Medicare PAC ID 2

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.

National Provider Directory

National Provider Directory

Locations

1100 Carson Ave
Ste 100
La Junta, CO 81050
Phone (719) 383-5959

1100 Carson Ave
Ste 201
La Junta, CO 81050
Phone (719) 383-5900

1100 Carson Ave
Ste 203
La Junta, CO 81050
Phone (719) 383-6425

Ownership & related parties

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Arkansas Valley Regional Medical CenterLa Junta, CO, CCN 061336 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 1, 1998
Arkansas Valley Regional Medical CenterLa Junta, CO, CCN 06Z336 Hospital Operational/Managerial Control (100%) Jul 1, 1998

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1649449075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CARSON",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810502751",
            "telephone_number": "719-383-6390",
            "fax_number": "719-383-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CARSON",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810502751",
            "telephone_number": "719-383-6390",
            "fax_number": "719-383-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS VALLEY REGIONAL MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-29",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "CROWELL",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "PHYSICIAN CLINIC DIRECTOR",
        "authorized_official_telephone_number": "719-383-6390"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "AR240008",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24982571",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ5303",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04102042",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AVRMC Physicians Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arkansas Valley Regional Medical Center Physicians Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Junta, CO

Sources for this page

Verify at the official NPI Registry.