NPIMap

Organization Active NPI

Salud Family Health

  • Federally Qualified Health Center (FQHC)
  • Fort Morgan, CO
National Provider Identifier
1740947407
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
709 E Riverview Ave
Fort Morgan, CO 80701-3263
Phone
(303) 697-2583
NPI assigned
Nov 17, 2021
Last updated
Jan 25, 2023By the provider in NPPES
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, CEO
Title
Ceo
Phone
(303) 892-6401

Specialties & licenses 1

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

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 names 2

  • Plan De Salud Del Valle, Inc Former legal business name
  • Fort Morgan High School Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740947407. Details of each certification follow.

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
CorporationNon-profit
Incorporated
Nov 17, 2021 in CO
Enrollment address
709 E Riverview Ave
Fort Morgan, CO 80701-3263

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

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

30 S 20th Ave
Unit A
Brighton, CO 80601
Phone (303) 655-1950

1830 Laporte Ave
Fort Collins, CO 80521
Phone (970) 416-6240

300 Lake St
Fort Morgan, CO 80701
Phone (970) 867-8422

300 Sherman St
Fort Morgan, CO 80701
Phone (970) 867-2998

415 Spruce St
Fort Morgan, CO 80701
Phone (970) 867-2080

605 Education Ave
Fort Morgan, CO 80701
Phone (970) 867-8253

709 E Riverview Ave
Fort Morgan, CO 80701

815 West St
Fort Morgan, CO 80701
Phone (303) 892-6401

Ownership & related parties

All disclosed owners & managing parties 3

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 Jan 1, 1978
Jesus a Tijerina Individual Corporate OfficerChair May 1, 1979
Joseph Daniel O'Connor Individual Corporate OfficerManager of Decision Support and Rev Mar 13, 2018
Operational/Managerial ControlManager of Decision Support and Rev Mar 13, 2018

Practitioners & affiliated clinicians

Practitioners 93

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 93

NPI Registry JSON

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1740947407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ROLLIE AVE",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211508",
            "telephone_number": "303-892-6401",
            "fax_number": "303-286-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 E RIVERVIEW AVE",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807013263",
            "telephone_number": "303-697-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALUD FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-17",
        "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": "CEO",
        "authorized_official_telephone_number": "303-892-6401",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plan De Salud Del Valle, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Fort Morgan High School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Morgan, CO

Sources for this page

Verify at the official NPI Registry.