NPIMap

Organization Active NPI

Grand River Hospital District

Doing business as Grand River Health Clinic West

  • Rural Health Clinic/Center
  • Parachute, CO
National Provider Identifier
1851347223
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
GRAND RIVER HOSPITAL DISTRICT
Doing business as
Grand River Health Clinic West
Practice address
201 Sipprelle Dr
Parachute, CO 81635
Phone
(970) 285-7046
NPI assigned
May 26, 2006
Last updated
Oct 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Authorized official

Name
James Curtis Coombs
Title
Ceo
Phone
(970) 625-3792

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

201 Sipprelle Dr
Parachute, CO 81635

Mailing address

501 Airport Rd
Rifle, CO 81650-8510
Phone (970) 625-1510

Other identifiers 1

IdentifierTypeStateIssuer
21604550MedicaidCO

Other names 1

  • GRAND RIVER HEALTH CLINIC WEST Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040305000881 CO Part A Provider - Rural Health Clinic 7113837469 Practice locations: Parachute, CO
O20040310000898 CO Part B Supplier - Clinic/Group Practice 7113837469 Receives reassigned benefits from 116 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Parachute, CO; Rifle, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851347223. Details of each certification follow.

Rural health clinic certification: CCN 063996

Legal name
GRAND RIVER HOSPITAL DISTRICT
Doing business as
GRAND RIVER HEALTH CLINIC WEST
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 11, 1997
Last certification
Jul 7, 2023
Ownership / control type
Non-profit – church related
Organization structure
OtherNon-profit
Enrollment address
201 Sipprelle Dr
Parachute, CO 81635-9234
Related CCNs
061317

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

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 2

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

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
06D0924410Grand River Health Clinic West201 Sipprelle, Parachute, CO 81635Provider-performed microscopyFeb 21, 2027

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Kelly Hilgers Individual W-2 Managing EmployeeAdministrative Director of Clinics Dec 20, 2019
James Coombs Individual Corporate OfficerCeo/Board Ex-Officio May 1, 2006
W-2 Managing EmployeeCeo/Board Ex-Officio May 1, 2006
Christina Bolin Individual Corporate OfficerCfo Jun 13, 2016
W-2 Managing EmployeeCfo Jun 13, 2016
Tammy Sours Individual Corporate DirectorBoard Vice President Jun 1, 2019
Jesse Wolf Individual Corporate DirectorBoard Member Jun 1, 2019
Mary J Glode Individual W-2 Managing EmployeeMedical Director Apr 1, 2016
Edward Weiss Individual Corporate DirectorBoard President Jun 1, 2019
Sharon M Raggio Individual Corporate DirectorBoard Member Jun 1, 2019
Raquel Mendizabal Individual Corporate DirectorBoard Member Jun 1, 2019
Grand River Hospital District Organization, Rifle, CO 5% Or Greater Direct Ownership Interest Jan 1, 1990 100%
Britt Jennel Choate Individual Corporate DirectorBoard Secretary/Treasurer Jun 1, 2019
Lee Canterbury Individual W-2 Managing EmployeePFS Director Jun 1, 2019

Owners & managing parties with NPI records 5

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

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
Grand River Health Medical CenterRifle, CO, CCN 061317 Hospital Operational/Managerial Control (100%) Apr 24, 1966
Grand River Medical CenterRifle, CO, CCN 06Z317 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 24, 1966
Grand River Health Care CenterRifle, CO, CCN 065381 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966
Grand River Primary CareRifle, CO, CCN 063980 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 24, 1966

Owned or controlled facilities with NPI records 4

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

Facilities with the same owner 4

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

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1851347223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 AIRPORT RD",
            "city": "RIFLE",
            "state": "CO",
            "postal_code": "816508510",
            "telephone_number": "970-625-1510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SIPPRELLE DR",
            "city": "PARACHUTE",
            "state": "CO",
            "postal_code": "81635",
            "telephone_number": "970-285-7046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND RIVER HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "COOMBS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CURTIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-625-3792"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21604550",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRAND RIVER HEALTH CLINIC WEST",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parachute, CO

Sources for this page

Verify at the official NPI Registry.