NPIMap

Organization Active NPI

St Mary's Hospital and Medical Center, Inc

Doing business as St Mary's Hospital & Medical Center Life Center OT/PT/SP

  • General Acute Care Hospital
  • Grand Junction, CO
National Provider Identifier
1821647801
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
ST MARY'S HOSPITAL AND MEDICAL CENTER, INC
Doing business as
St Mary's Hospital & Medical Center Life Center OT/PT/SP
Practice address
2686 Patterson Rd
Grand Junction, CO 81506-8899
Phone
(970) 298-6100
Fax
(970) 298-6159
NPI assigned
Sep 11, 2019
Last updated
Nov 17, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Authorized official

Name
Ashley Thurow
Title
Cfo
Phone
(970) 298-2020

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

2686 Patterson Rd
Grand Junction, CO 81506-8899

Mailing address

2686 Patterson Rd
Entrance 40
Grand Junction, CO 81506-8817
Phone (970) 298-2764

Other names 1

  • St Mary's Hospital & Medical Center Life Center OT/PT/SP Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071205000395 CO Part A Provider - Hospital 1557267069 3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rifle, CO; Montrose, CO; Grand Junction, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821647801. Details of each certification follow.

Hospital certification: CCN 060023

Legal name
ST MARYS HOSPITAL AND MEDICAL CENTER INC
Doing business as
INTERMOUNTAIN HEALTH ST. MARY'S REGIONAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 25, 2015
Beds
346
Ownership / control type
Church
Organization structure
CorporationNon-profit
Incorporated
Mar 24, 1975 in CO
Enrollment address
2635 N 7TH St
Grand Junction, CO 81501-8209
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Intermountain Health St. Mary's Regional HospitalCCN 060023 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Church
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Colorado West ER Physic8 organizations share this tax ID, including this one
Part of
Sisters of Charity of Leavenworth Health System Inc

Other organizations with this tax ID 7

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

Ownership & related parties

All disclosed owners & managing parties 16

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

NameRoleSinceShare
Tom Benton Individual Corporate DirectorBoard Member Jan 1, 2022
Mark C Griffin Individual Corporate DirectorBoard Member Jan 1, 2020
John Merrick Taggart Individual Corporate DirectorBoard Member Jan 1, 2024
Amy Lynn Davis Individual Corporate DirectorBoard Member Jan 1, 2024
Teyen P. Shiao Individual Corporate DirectorBoard Member Mar 1, 2025
Angela Padalecki Individual Corporate DirectorBoard Member Jan 1, 2023
Jeffrey Taets Individual Corporate DirectorBoard Member Jan 1, 2021
Vincent Donohue Individual Corporate Director Jan 1, 2025
W-2 Managing Employee Jan 1, 2025
Vance Wagner Individual Corporate DirectorBoard Member Jan 1, 2018
Timothy Foster Individual Corporate Director May 1, 2023
Sisters of Charity of Leavenworth Health System Inc Organization, Broomfield, CO Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Dec 19, 1972 100%
Bryan Johnson Individual Corporate OfficerPresident Aug 9, 2019
Corporate DirectorPresident Aug 9, 2019
W-2 Managing EmployeePresident Aug 9, 2019
Intermountain Health Care, Inc Organization, Salt Lake City, UT Non-profit, Chain home office Operational/Managerial Control Apr 1, 2022
Lenna Watson Individual Corporate DirectorBoard Member Jan 1, 2020
Brian Hill Individual Corporate DirectorBoard Member Jul 1, 2022
Joseph Carlson Individual Corporate DirectorBoard Member Jan 1, 2022

Owners & managing parties with NPI records 6

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

Practitioners & affiliated clinicians

Affiliated clinicians 717

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

View all 717

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1821647801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2686 PATTERSON RD",
            "address_2": "ENTRANCE 40",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068817",
            "telephone_number": "970-298-2764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2686 PATTERSON RD",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815068899",
            "telephone_number": "970-298-6100",
            "fax_number": "970-298-6159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY'S HOSPITAL AND MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SISTERS OF CHARITY OF LEAVENWORTH HEALTH SYSTEM INC",
        "enumeration_date": "2019-09-11",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "THUROW",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "970-298-2020"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Mary's Hospital & Medical Center Life Center OT/PT/SP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.