NPIMap

Organization Active NPI

East Phillips County Hospital District

Doing business as Melissa Memorial Hospital

  • Critical Access Hospital
  • Holyoke, CO
National Provider Identifier
1891733879
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
0586 Issued in CO
Legal business name
EAST PHILLIPS COUNTY HOSPITAL DISTRICT
Doing business as
Melissa Memorial Hospital
Practice address
1001 E Johnson Street
Holyoke, CO 80734-1854
Phone
(970) 854-2241
Fax
(970) 854-3821
NPI assigned
Jun 3, 2006
Last updated
Feb 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Authorized official

Name
Michael Hassell
Title
Ceo
Phone
(970) 854-2241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 0586 CO Primary

Addresses

Primary practice location

1001 E Johnson Street
Holyoke, CO 80734-1854

Mailing address

1001 E Johnson Street
Holyoke, CO 80734-1854
Phone (970) 854-2241

Other identifiers 1

IdentifierTypeStateIssuer
05038005MedicaidCO

Other names 1

  • Melissa Memorial Hospital Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040331000584 CO Part B Supplier - Clinic/Group Practice 9638161615 Receives reassigned benefits from 47 practitioners
4 other NPIs on this enrollment
Practice locations: Holyoke, CO
O20080626000605 CO Part A Provider - Critical Access Hospital 9638161615 Receives reassigned benefits from 42 practitioners
Practice locations: Holyoke, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891733879. Details of each certification follow.

Hospital certification: CCN 061305

Legal name
EAST PHILLIPS COUNTY HOSPITAL DISTRICT
Doing business as
MELISSA MEMORIAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Aug 3, 2000
Last certification
Sep 20, 2023
Beds
16
Ownership / control type
Hospital district or authority
Organization structure
GovernmentProprietary
Enrollment address
1001 E Johnson St
Holyoke, CO 80734-1854
Other Hospital Practice Location

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 4

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Melissa Memorial HospitalCCN 061305 · 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
Tax ID family
Melissa Memorial Hospital9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Steve Young Individual Operational/Managerial ControlBoard Member Jan 1, 1993
Christopher J Alvarez Individual W-2 Managing EmployeeAd;Cfo Feb 16, 2026
Operational/Managerial ControlCfo Feb 16, 2026
Sheila Gift Individual Operational/Managerial ControlBoard Member Feb 1, 2015
Maribeth Olson Individual W-2 Managing EmployeeAd;Coo Feb 16, 2026
Operational/Managerial ControlCoo Feb 16, 2026
Jimmie Bailey Individual Corporate OfficerCoo Aug 16, 2021
W-2 Managing EmployeeCoo Aug 16, 2021
Operational/Managerial ControlCoo Aug 16, 2021
Gary Rahe Individual Operational/Managerial ControlBoard Member May 1, 2008
Michael Hassell Individual Corporate OfficerCeo Nov 7, 2022
W-2 Managing Employee Nov 7, 2022
Operational/Managerial Control Nov 7, 2022
Angela Powell Individual Operational/Managerial ControlBoard Member May 1, 2014
Julie Wiebke Individual Operational/Managerial Control Apr 27, 2021
East Phillips County Hospital District Organization, Holyoke, CO 5% Or Greater Direct Ownership Interest Jul 11, 1966 100%
Jessie Diamond Individual W-2 Managing EmployeeManager Feb 25, 2026
Operational/Managerial ControlMedical Staff Coordinator Feb 25, 2026

Owners & managing parties with NPI records 4

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
Melissa Memorial HospitalHolyoke, CO, CCN 06Z305 Hospital 5% Or Greater Direct Ownership Interest (100%) Jul 11, 1966
Family Practice of HolyokeHolyoke, CO, CCN 063400 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1966

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 51

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 51

Affiliated clinicians 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707177600000",
    "number": "1891733879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E JOHNSON STREET",
            "city": "HOLYOKE",
            "state": "CO",
            "postal_code": "807341854",
            "telephone_number": "970-854-2241",
            "fax_number": "970-854-3821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E JOHNSON STREET",
            "city": "HOLYOKE",
            "state": "CO",
            "postal_code": "807341854",
            "telephone_number": "970-854-2241",
            "fax_number": "970-854-3821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST PHILLIPS COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2024-02-06",
        "certification_date": "2023-01-04",
        "status": "A",
        "authorized_official_last_name": "HASSELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "970-854-2241"
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CO",
            "license": "0586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05038005",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melissa Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Melissa Memorial Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holyoke, CO

Sources for this page

Verify at the official NPI Registry.