NPIMap

Organization Active NPI

Summit Community Care Clinic, Inc.

Doing business as Elevated Community Health

  • Federally Qualified Health Center (FQHC)
  • Frisco, CO
National Provider Identifier
1831219328
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SUMMIT COMMUNITY CARE CLINIC, INC.
Doing business as
Elevated Community Health
Practice address
360 Peak One Drive
Suite 100
Frisco, CO 80443
Phone
(970) 668-4040
Fax
(970) 668-6699
NPI assigned
Mar 30, 2007
Last updated
Dec 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Authorized official

Name
Josh Cogdill
Title
Ceo
Phone
(970) 668-4040

Specialties & licenses 1

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

Addresses

Primary practice location

360 Peak One Drive
Suite 100
Frisco, CO 80443

Mailing address

PO Box 4337
360 Peak One Drive, Suite 100
Frisco, CO 80443-4337
Phone (970) 668-4040

Other names 1

  • Elevated Community 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
O20120517000087 CO Part B Supplier - Clinic/Group Practice 8022284074 Receives reassigned benefits from 18 practitioners
1 other NPI on this enrollment
Practice locations: Frisco, CO
O20121220000364 CO Part A Provider - Federally Qualified Health Center (FQHC) 8022284074 Practice locations: Frisco, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1831219328. Details of each certification follow.

Federally qualified health center certification: CCN 061923

Legal name
SUMMIT COMMUNITY CARE CLINIC INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 22, 2012
Last certification
Aug 22, 2012
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
May 24, 2004 in CO
Enrollment address
360 Peak One Drive
Suite 100
Frisco, CO 80443-4337

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Deb Crook Individual Corporate Director Nov 18, 2014
Patricia Kopystianskyj Individual Corporate DirectorBoard Member - President Oct 26, 2011
Anthony Pestello Individual Corporate Director Oct 25, 2017
Dana Cottrell Individual Corporate DirectorBoard Member Oct 26, 2011
Nicole Zador Individual Other Oct 27, 2021
Daniel Becker Individual Corporate OfficerInterim Ceo Oct 1, 2023
W-2 Managing EmployeeInterim Ceo Oct 1, 2023
Ursula Karina Zuniga Individual Other Oct 15, 2019
David Nicoli Individual Corporate Director Oct 26, 2016
Norman Stoller Individual Corporate Director Sep 22, 2015
Maryjo Zweig Individual Other Oct 24, 2018
Julie Thebeau Individual Other Oct 23, 2019
Richard O'Brien Individual Corporate Director Sep 21, 2015
Wilson Blake Individual Corporate DirectorBoard Member Oct 25, 2017
Braden McMillan Individual Corporate Director Jun 22, 2016
Judi Lapoint Individual Other Oct 24, 2018
Dustin Stokes Individual Other Oct 27, 2021
James K Beckmann Individual Other Oct 27, 2021

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1831219328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4337",
            "address_2": "360 PEAK ONE DRIVE, SUITE 100",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "804434337",
            "telephone_number": "970-668-4040",
            "fax_number": "970-668-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 PEAK ONE DRIVE",
            "address_2": "SUITE 100",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "80443",
            "telephone_number": "970-668-4040",
            "fax_number": "970-668-6699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT COMMUNITY CARE CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "COGDILL",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-668-4040"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elevated Community Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frisco, CO

Sources for this page

Verify at the official NPI Registry.