NPIMap

Organization Active NPI

Salud Family Health

  • Federally Qualified Health Center (FQHC)
  • Trinidad, CO
National Provider Identifier
1851805709
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SALUD FAMILY HEALTH
Practice address
911 Robinson Ave
Trinidad, CO 81082-2832
Phone
(303) 697-2583
Fax
(719) 422-8808
NPI assigned
Nov 29, 2017
Last updated
Jan 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Authorized official

Name
David Madsen
Title
Cfo
Phone
(720) 322-9405

Specialties & licenses 1

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

Addresses

Primary practice location

911 Robinson Ave
Trinidad, CO 81082-2832

Mailing address

203 S Rollie Ave
Fort Lupton, CO 80621-1508
Phone (303) 892-6401

Other identifiers 1

IdentifierTypeStateIssuer
900160117MedicaidCO

Other names 1

  • Plan De Salud Del Valle, Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180305000562 CO Part A Provider - Federally Qualified Health Center (FQHC) 3173433398 Practice locations: Trinidad, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851805709. Details of each certification follow.

Federally qualified health center certification: CCN 061980

Legal name
SALUD FAMILY HEALTH
Doing business as
SALUD FAMILY HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 21, 2018
Last certification
Feb 21, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 1, 2017 in CO
Enrollment address
911 Robinson Ave
Trinidad, CO 81082-2832

Other NPIs with the same Medicare PAC ID 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Salud Family Health18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

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
Colleen L Laeger Individual Corporate OfficerVice Chair Jan 1, 1978
Jesus a Tijerina Individual Corporate OfficerChair May 1, 1979
David Madsen Individual Contracted Managing EmployeeCfo Aug 24, 2016
Operational/Managerial ControlCfo Aug 24, 2016
Joseph Daniel O'Connor Individual Corporate OfficerBilling Mar 13, 2018

NPI Registry JSON

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

{
    "created_epoch": "1511913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1851805709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S ROLLIE AVE",
            "city": "FORT LUPTON",
            "state": "CO",
            "postal_code": "806211508",
            "telephone_number": "303-892-6401",
            "fax_number": "303-892-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 ROBINSON AVE",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822832",
            "telephone_number": "303-697-2583",
            "fax_number": "719-422-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALUD FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-29",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A",
        "authorized_official_last_name": "MADSEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "720-322-9405"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "900160117",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plan De Salud Del Valle, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Trinidad, CO

Sources for this page

Verify at the official NPI Registry.