NPIMap

Organization Active NPI

Prowers County Hospital District

Doing business as Prowers Medical Center

  • Critical Access Hospital
  • Lamar, CO
National Provider Identifier
1821052929
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
010217 Issued in CO
Legal business name
PROWERS COUNTY HOSPITAL DISTRICT
Doing business as
Prowers Medical Center
Practice address
401 Kendall Drive
Lamar, CO 81052-3942
Phone
(719) 336-4343
Fax
(719) 336-7207
NPI assigned
Apr 14, 2006
Last updated
Oct 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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

Authorized official

Name
Karen L Bryant
Title
C.O.O.
Phone
(719) 336-5147

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X NU
Critical Access Hospital 282NC0060X 010217 CO Primary

Addresses

Primary practice location

401 Kendall Drive
Lamar, CO 81052-3942

Mailing address

401 Kendall Drive
Lamar, CO 81052-3942
Phone (719) 336-4343

Other identifiers 1

IdentifierTypeStateIssuer
05007000MedicaidCO

Other names 1

  • Prowers Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031113000509 CO Part B Supplier - Clinic/Group Practice 4486568508 Receives reassigned benefits from 118 practitioners
Practice locations: Lamar, CO
O20070308000600 CO Part A Provider - Critical Access Hospital 4486568508 Receives reassigned benefits from 3 practitioners
Practice locations: Lamar, CO
O20090202000314 CO Part A Provider - Critical Access Hospital 4486568508 Receives reassigned benefits from 51 practitioners
Practice locations: Lamar, CO

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1821052929. Details of each certification follow.

Hospital certification: CCN 06Z323

Legal name
PROWERS COUNTY HOSPITAL DISTRICT
Doing business as
PROWERS MEDICAL CENTER
Organization structure
GovernmentNon-profit
Enrollment address
401 Kendall Dr
Prowers Medical Center
Lamar, CO 81052-3942
Other Hospital Practice Location

Hospital certification: CCN 061323

Legal name
PROWERS COUNTY HOSPITAL DISTRICT
Doing business as
PROWERS MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 1, 2004
Last certification
Apr 1, 2026
Beds
25
Ownership / control type
Hospital district or authority
Organization structure
GovernmentNon-profit
Enrollment address
401 Kendall Dr
Lamar, CO 81052-3942

Hospital certification: CCN 060007

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
PROWERS MEDICAL CENTER
Certification status
Terminated Other: provider status change, Jul 31, 2004
Provider type (POS)
Hospital – Short-term
Participating since
Sep 1, 1968
Last certification
Oct 20, 1994
Beds
40
Ownership / control type
Hospital district or authority
Facility address
401 Kendall Drive
Lamar, CO 81052

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

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Prowers Medical CenterCCN 061323 · All quality measures
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

403 Kendall Dr
Ste C
Lamar, CO 81052
Phone (719) 336-6767

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Lisa a Dodkins Individual W-2 Managing EmployeeRevenue Cycle Director Sep 1, 2022
W-2 Managing Employee Sep 1, 2022
Karen Bryant Individual Corporate Director Jan 6, 2009
Corporate OfficerCoo Aug 1, 2004 5%
Prowers County Hospital District Organization, Lamar, CO 5% Or Greater Direct Ownership Interest Jan 6, 2009
Tina Sandoval Individual Corporate OfficerChief Clinical Officer Aug 28, 2017 5%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
Prowers Medical Center Home HealthLamar, CO, CCN 067295 Home health agency 5% Or Greater Direct Ownership Interest Dec 1, 2008
Lamar Medical ClinicLamar, CO, CCN 068512 Rural health clinic 5% Or Greater Direct Ownership Interest Jan 26, 2009

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 2

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

Practitioners & affiliated clinicians

Practitioners 120

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 120

Affiliated clinicians 119

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

View all 119

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1821052929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 KENDALL DRIVE",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810523942",
            "telephone_number": "719-336-4343",
            "fax_number": "719-336-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KENDALL DRIVE",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810523942",
            "telephone_number": "719-336-4343",
            "fax_number": "719-336-7207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROWERS COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-14",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "719-336-5147"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CO",
            "license": "010217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05007000",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prowers Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lamar, CO

Sources for this page

Verify at the official NPI Registry.