NPIMap

Organization Active NPI

East Phillips County Hospital District

Doing business as Melissa Memorial Hospital SwingBed

  • Medicare Defined Swing Bed Hospital Unit
  • Holyoke, CO
National Provider Identifier
1912915893
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medicare Defined Swing Bed Hospital UnitTaxonomy code 275N00000X
License
0586 Issued in CO
Legal business name
EAST PHILLIPS COUNTY HOSPITAL DISTRICT
Doing business as
Melissa Memorial Hospital SwingBed
Practice address
1001 E Johnson Street
Holyoke, CO 80734-1854
Phone
(970) 854-2241
Fax
(970) 854-3821
NPI assigned
Aug 4, 2006
Last updated
Jan 4, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
EAST PHILLIPS COUNTY HOSPITAL DISTRICTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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
Medicare Defined Swing Bed Hospital Unit 275N00000X 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 names 1

  • Melissa Memorial Hospital SwingBed Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080626000643 CO Part A Provider - Critical Access Hospital 9638161615 Receives reassigned benefits from 31 practitioners
Practice locations: Holyoke, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1912915893. Details of each certification follow.

Hospital certification: CCN 06Z305

Legal name
EAST PHILLIPS COUNTY HOSPITAL DISTRICT
Doing business as
MELISSA MEMORIAL HOSPITAL
Organization structure
OtherNon-profit
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).

National Provider Directory

National Provider Directory
Tax ID family
East Phillips County Hospital District9 organizations share this tax ID, including this one
Part of
East Phillips County Hospital District

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 OfficerCco Aug 16, 2021
W-2 Managing EmployeeCco Aug 16, 2021
Operational/Managerial ControlCco Aug 16, 2021
Gary Rahe Individual Operational/Managerial ControlBoard Member May 1, 2008
Michael Hassell Individual Corporate OfficerCeo Nov 7, 2022
W-2 Managing EmployeeCeo Nov 7, 2022
Operational/Managerial ControlCeo Nov 7, 2022
Angela Powell Individual Operational/Managerial ControlBoard Member May 1, 2014
Julie Wiebke Individual Operational/Managerial ControlBoard Member 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 EmployeeMedical Staff Coordinator Oct 9, 2019
Operational/Managerial ControlMedical Staff Coordinator Oct 9, 2019

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 061305 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 39

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 39

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672790400000",
    "number": "1912915893",
    "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": "YES",
        "parent_organization_legal_business_name": "EAST PHILLIPS COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2006-08-04",
        "last_updated": "2023-01-04",
        "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": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "CO",
            "license": "0586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melissa Memorial Hospital SwingBed",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Melissa Memorial Hospital SwingBed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Holyoke, CO

Sources for this page

Verify at the official NPI Registry.