High Plains Community Health Center Incorporated

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED

Doing business as

High Plains Wiley Clinic

Practice address

302 Main
Wiley, CO 81092

Phone

(719) 829-4286

Fax

(719) 829-4288

NPI assigned

Jul 25, 2013

Last updated

Apr 15, 2014By the provider in NPPES

Organization subpart

Yes

Parent organization

HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATEDAs reported in NPPES

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

Authorized official

Name

Robert Jay Brooke

Title

Executive Director

Phone

(719) 336-0261

Specialties & licenses 1

Addresses

Other names 1

• High Plains Wiley Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912349465. Details of each certification follow.

• CCN 061945 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 061945

Legal name

HIGH PLAINS WILEY CLINIC

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Apr 16, 2014

Last certification

Apr 16, 2014

Ownership / control type

For profit – corporation

Facility address

302 Main Street
Wiley, CO 81092

Other NPIs on the same Medicare enrollment 3

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

• High Plains Community Health Center Incorporated

  dba Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Lamar, CO
  • NPI 1609240894

  O20040818000092

  Same enrollment
• High Plains Community Health Center Incorporated

  dba High Plains Holly Clinic

  • Federally Qualified Health Center (FQHC)
  • Holly, CO
  • NPI 1932596350

  O20040818000092

  Same enrollment
• High Plains Community Health Center, Incorporated

  • Federally Qualified Health Center (FQHC)
  • Lamar, CO
  • NPI 1700889151

  O20040818000092

  Same enrollment

Part of

High Plains Community H

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1912349465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 KENDALL DR",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810523939",
            "telephone_number": "719-336-0261",
            "fax_number": "719-336-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 MAIN",
            "city": "WILEY",
            "state": "CO",
            "postal_code": "81092",
            "telephone_number": "719-829-4286",
            "fax_number": "719-829-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HIGH PLAINS COMMUNITY HEALTH CENTER INCORPORATED",
        "enumeration_date": "2013-07-25",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "BROOKE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "719-336-0261"
    },
    "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": "High Plains Wiley Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachel R Buck, FNP-C
• County Line Health Clinic
• County of Kiowa Hospital District (Wiley Medical Clinic)
• Kiowa County Hospital District (Wiley Medical Clinic)
• Seondra Paintin, R.N.
• Rooted Within, Inc
• Catherine Ruth Tempel, LPC
• Monica Lynn Tempel, APRN

• Federally Qualified Health Center (FQHC) in Wiley, CO
• Providers in Wiley, CO by specialty
• Federally Qualified Health Center (FQHC) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.