NPIMap

Organization Active NPI

Clinica Campesina Family Health Services

Doing business as Clinica Family Health

  • Federally Qualified Health Center (FQHC)
  • Westminster, CO
National Provider Identifier
1811279136
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CLINICA CAMPESINA FAMILY HEALTH SERVICES
Doing business as
Clinica Family Health
Practice address
8510 Bryant St FL 2
Westminster, CO 80031-3844
Phone
(303) 665-3036
Fax
(303) 665-9566
NPI assigned
Sep 13, 2011
Last updated
Feb 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Authorized official

Name
Brian J Johnston
Title
Cfo
Phone
(303) 926-0625

Specialties & licenses 1

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

Addresses

Primary practice location

8510 Bryant St FL 2
Westminster, CO 80031-3844

Mailing address

1735 S Public Rd
Lafayette, CO 80026-7093

Other names 1

  • Clinica Family Health Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031106000276 CO Part B Supplier - Clinic/Group Practice 7315850484 Receives reassigned benefits from 246 practitioners
29 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Broomfield, CO; Longmont, CO; Lafayette, CO; Boulder, CO
O20111114000386 CO Part A Provider - Federally Qualified Health Center (FQHC) 7315850484 Practice locations: Westminster, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1811279136. Details of each certification follow.

Federally qualified health center certification: CCN 061913

Legal name
CLINICA CAMPESINA FAMILY HEALTH SERVICES
Doing business as
CLINICA FAMILY HEALTH SERVICES FEDERAL HEIGHTS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 19, 2012
Last certification
Jan 19, 2012
Ownership / control type
Non-profit – other
Organization structure
CorporationNon-profit
Incorporated
Jul 22, 1977 in CO
Enrollment address
8510 Bryant St
FL 2
Westminster, CO 80031-4029

Other NPIs with the same Medicare PAC ID 8

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

Other NPIs on the same Medicare enrollment 15

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

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2203649Clinica Family Health Services - Westminster8510 N Bryant St, 2ND Floor, Westminster, CO 80031Provider-performed microscopyDec 3, 2026

National Provider Directory

National Provider Directory

Locations

1735 S Public Rd
Ste 201
Lafayette, CO 80026

515 Coffman St
Longmont, CO 80501
Phone (303) 618-1273

8510 Bryant St
Fl 2
Westminster, CO 80031
Phone (303) 854-8004

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Brian Johnston Individual Corporate OfficerCfo Nov 29, 2022
Corporate DirectorCfo Nov 29, 2022
W-2 Managing EmployeeCfo Nov 29, 2022

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Clinica Family HealthNederland, CO, CCN 061033 Federally qualified health center Other Jun 1, 2022
Clinica Family Health ServicesBlack Hawk, CO, CCN 061034 Federally qualified health center Other Jun 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1811279136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1735 S PUBLIC RD",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800267093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8510 BRYANT ST FL 2",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800313844",
            "telephone_number": "303-665-3036",
            "fax_number": "303-665-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA CAMPESINA FAMILY HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-926-0625"
    },
    "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": "Clinica Family Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westminster, CO

Sources for this page

Verify at the official NPI Registry.