Peak Vista Community Health Centers

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

License

18Q653 Issued in CO

Legal business name

PEAK VISTA COMMUNITY HEALTH CENTERS

Practice address

412 North C Street
Cripple Creek, CO 80813

Phone

(719) 689-9230

Fax

(719) 689-9236

NPI assigned

Oct 9, 2009

Organization subpart

Yes

Parent organization

PEAK VISTA COMMUNITY HEALTH CENTERSAs reported in NPPES

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

Authorized official

Name

Tracy Narvet

Title

Cfo

Phone

(719) 344-6188

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cripple Creek-Victor Mountain Health Center Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 061907

Legal name

PEAK VISTA C H C - CRIPPLE CREEK-VICTOR MTN HEALTH

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Feb 26, 2010

Last certification

Feb 26, 2010

Ownership / control type

For profit – partnership

Facility address

412 North C Street
Cripple Creek, CO 80813

Part of

Peak Vista Community Health Center

Member of 1

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

• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1437622206

  Member Of

  NPD member

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

{
    "created_epoch": "1255046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1659606580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 N ACADEMY BLVD STE 130",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175152",
            "telephone_number": "719-632-5700",
            "fax_number": "719-344-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 NORTH C STREET",
            "city": "CRIPPLE CREEK",
            "state": "CO",
            "postal_code": "80813",
            "telephone_number": "719-689-9230",
            "fax_number": "719-689-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK VISTA COMMUNITY HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEAK VISTA COMMUNITY HEALTH CENTERS",
        "enumeration_date": "2009-10-09",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "NARVET",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "719-344-6188"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CO",
            "license": "18Q653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05638267",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cripple Creek-Victor Mountain Health Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Cripple Creek-Victor Mountain Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Federally Qualified Health Center (FQHC) in Cripple Creek, CO
• Providers in Cripple Creek, CO by specialty
• Federally Qualified Health Center (FQHC) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.