NPIMap

Organization Active NPI

Camelot Health Care, Inc.

Doing business as Valley View Health Care Center

  • Skilled Nursing Facility
  • Canon City, CO
National Provider Identifier
1679552301
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
392 Issued in CO
Legal business name
CAMELOT HEALTH CARE, INC.
Doing business as
Valley View Health Care Center
Practice address
2120 N 10TH St
Canon City, CO 81212-2211
Phone
(719) 275-7569
Fax
(719) 275-3890
NPI assigned
Jan 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Authorized official

Name
Ms. Mary Koretke
Title
Director of Reimbursement
Phone
(303) 987-3088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 392 CO Primary

Addresses

Primary practice location

2120 N 10TH St
Canon City, CO 81212-2211

Mailing address

12136 W Bayaud Ave
Suite 200
Lakewood, CO 80228-2115
Phone (303) 987-3088

Other identifiers 1

IdentifierTypeStateIssuer
05651468MedicaidCO

Other names 1

  • Valley View Health Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100225000746 CO Part A Provider - Skilled Nursing Facility 9537203799 Practice locations: Canon City, CO

Skilled nursing facility certification: CCN 065347

Legal name
CAMELOT HEALTH CARE, INC
Doing business as
VALLEY VIEW CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 15, 1996
Last certification
May 15, 2024
Beds
60
Ownership / control type
Partnership
Multi-facility organization
Vivage Beecan
Organization structure
CorporationProprietary
Incorporated
Sep 21, 2006 in CO
Enrollment address
2120 N 10TH St
Canon City, CO 81212-2211
Nursing home name
VALLEY VIEW CARE CENTER
Affiliated entity
VIVAGE SENIOR LIVING

Care Compare: Nursing home

Medicare Care Compare
Listed as
Valley View Care CenterCCN 065347 · All quality measures
Overall star rating
3 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Partnership
Certified
Apr 15, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6058.2 residents per day on average
Chain
Vivage Senior Living6 facilities in the chain
Penalties (3 years)
1Fines totaling $8,281

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

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
Peter a Derego Individual W-2 Managing Employee May 1, 2016 100%
John D Brammeier Individual 5% Or Greater Direct Ownership Interest Apr 1, 2015 25%
Corporate OfficerTreasurer of QP Health Care Serv Dec 31, 2011 18%
Mary E Koretke Individual W-2 Managing EmployeeDirector of Reimbursement Jan 4, 2010
Jay H Moskowitz Individual 5% Or Greater Direct Ownership Interest Apr 1, 2015 75%
Corporate OfficerCeo of QP Health Care Services Dec 31, 2011 82%
QP Health Care Services LLC Organization, Glendale, CO For-profit Operational/Managerial Control Apr 1, 2024
Pinon Management, LLC Organization, Lakewood, CO LLC, Management services company, For-profit Operational/Managerial Control Dec 31, 2011 100%

Facilities with the same owner 13

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

View all 13

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265328000000",
    "number": "1679552301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12136 W BAYAUD AVE",
            "address_2": "SUITE 200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282115",
            "telephone_number": "303-987-3088",
            "fax_number": "303-987-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 N 10TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812122211",
            "telephone_number": "719-275-7569",
            "fax_number": "719-275-3890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMELOT HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2010-02-05",
        "status": "A",
        "authorized_official_last_name": "KORETKE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "DIRECTOR OF REIMBURSEMENT",
        "authorized_official_telephone_number": "303-987-3088",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CO",
            "license": "392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05651468",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Valley View Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canon City, CO

Sources for this page

Verify at the official NPI Registry.