NPIMap

Organization Active NPI

Salud Family Health

  • Federally Qualified Health Center (FQHC)
  • Estes Park, CO
National Provider Identifier
1720111677
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SALUD FAMILY HEALTH
Practice address
1950 Redtail Hawk Dr
Estes Park, CO 80517-9780
Phone
(303) 697-2583
Fax
(970) 577-3464
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
John Santistevan
Title
President/Ceo
Phone
(303) 892-6401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1950 Redtail Hawk Dr
Estes Park, CO 80517-9780

Mailing address

203 S Rollie Ave
Billing Dept-Credentialist
Fort Lupton, CO 80621-1508
Phone (303) 286-4560

Other identifiers 1

IdentifierTypeStateIssuer
05638358MedicaidCO

Other names 1

  • Plan De Salud Del Valle Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100604000399 CO Part A Provider - Federally Qualified Health Center (FQHC) 3173433398 Practice locations: Estes Park, CO

Federally qualified health center certification: CCN 061864

Legal name
SALUD FAMILY HEALTH
Doing business as
SALUD FAMILY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 14, 1998
Last certification
Sep 14, 1998
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jun 21, 1971 in CO
Enrollment address
1950 Redtail Hawk Dr
Estes Park, CO 80517-9780
Related CCNs
061810

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

Other NPIs with the same Medicare PAC ID 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Salud Family Health18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Colleen L Laeger Individual Corporate OfficerVice Chair, Board Member Jan 1, 1978
Jesus a Tijerina Individual Corporate DirectorChairman of the Board Jan 7, 1970
David Madsen Individual Operational/Managerial ControlCfo Aug 24, 2016
John Santistevan Individual Corporate DirectorCeo Sep 27, 1996
Joseph Daniel O'Connor Individual Corporate DirectorManager of Revenue Cycle Mar 13, 2018
Operational/Managerial ControlManager of Decision Support Mar 13, 2018

Practitioners & affiliated clinicians

Practitioners 75

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

View all 75

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1720111677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ROLLIE AVE",
            "address_2": "BILLING DEPT-CREDENTIALIST",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211508",
            "telephone_number": "303-286-4560",
            "fax_number": "303-286-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 REDTAIL HAWK DR",
            "city": "ESTES PARK",
            "state": "CO",
            "postal_code": "805179780",
            "telephone_number": "303-697-2583",
            "fax_number": "970-577-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALUD FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "SANTISTEVAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "303-892-6401"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05638358",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plan De Salud Del Valle Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Estes Park, CO

Sources for this page

Verify at the official NPI Registry.