Salud Family Health
Organization Active NPI Federally Qualified Health Center (FQHC) · Fort Morgan, CO
NPI 1740947407 · NPPES record last updated Jan 25, 2023
Key facts
- NPI
- 1740947407
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- SALUD FAMILY HEALTH
- Practice address
- 709 E Riverview Ave
Fort Morgan, CO 80701-3263 - Phone
- (303) 697-2583
- NPI assigned
- Nov 17, 2021
- Organization subpart
- No
Authorized official
- Name
- John Santistevan, CEO
- Title
- Ceo
- Phone
- (303) 892-6401
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 14
Practitioners 101
-
Michael W Allen, DO
-
Joshua F. Bailey, M.D.
-
Michael O Beer, PA
-
Matthew S Brett, MD
-
Lauren Brink, PA
-
Laura E Clark, PA-C
-
Ysell D Cordoba, LPC
-
Caitlyn Murphy Davis, PA-C
-
Pradeep Dhar, MD
-
Pedro Felix Diaz Ramos, LCSW
-
Ann E Dominguez, MD
-
Hans D Elzinga, MD
-
Carlos Anibal Estrella-Rodriguez, MA LPC
-
Tillman Farley, MD
-
Karen I Fedde, MD
-
Andrea Flores, NP
-
Kale Flory, D.O.
-
John Fontenot, MD
-
Elizabeth Frias, LCSW-LAC
-
Alison Marie Godinez, PA-C
-
Sonia Graber, FNP
-
Laura Michelle Grunewald, N.P.
-
Lauren Saboe Hughes, MD, MPH, MSC, MHCDS
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in CO
Federally qualified health center certification: CCN 061030
- Legal name
- SALUD FAMILY HEALTH
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Dec 14, 2021
- Last certification
- Dec 14, 2021
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Nov 17, 2021 in CO
- Enrollment address
- 709 E Riverview Ave
Fort Morgan, CO 80701-3263
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Colleen L Laeger |
Corporate Officer |
Jan 1, 1978 | |
| Jesus a Tijerina |
Corporate Officer |
May 1, 1979 | |
| Joseph Daniel O'Connor |
Corporate Officer |
Mar 13, 2018 | |
| Operational/Managerial Control |
Mar 13, 2018 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031126000756 | CO | Part B Supplier - Clinic/Group Practice | 3173433398 |
Receives reassigned benefits from 93 practitioners 5 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fort Morgan, CO; Frederick, CO; Longmont, CO; Sterling, CO; Trinidad, CO; Aurora, CO; Brighton, CO; Commerce City, CO… |
| O20211216001288 | CO | Part a Provider - Federally Qualified Health Center (FQHC) | 3173433398 | Practice locations: Fort Morgan, CO |
National Provider Directory
Locations
1830 Laporte Ave
Fort Collins, CO 80521
Phone (970) 416-6240
709 E Riverview Ave
Fort Morgan, CO 80701
415 Spruce St
Fort Morgan, CO 80701
Phone (970) 867-2080
300 Lake St
Fort Morgan, CO 80701
Phone (970) 867-8422
729 E Railroad Ave
Fort Morgan, CO 80701
Phone (970) 867-0300
220 E Rogers Rd
Longmont, CO 80501
Phone (303) 776-3250
1410 S 7th Ave
Sterling, CO 80751
Phone (970) 526-2589
928 Smith Ave
Trinidad, CO 81082
Phone (719) 422-8810
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
709 E Riverview Ave
Fort Morgan, CO 80701-3263
Mailing address
203 S Rollie Ave
Fort Lupton, CO 80621-1508
Phone (303) 892-6401
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9000199754 | Medicaid | CO |
Other names
- Plan De Salud Del Valle, Inc
- Fort Morgan High School
Other providers in Fort Morgan, CO
- Salud Family Health
- Salud Family Health
- Salud Family Health
- Salud Family Health
- Salud Family Health
- Salud Family Health
- Salud Family Health
- Salud Family Health
- Sami Ride LLC
- David Wayne Sanchez
All providers in Fort Morgan, CO · Federally Qualified Health Center (FQHC) in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.