NPIMap

Organization Active NPI

Kit Carson County Health Services District

Doing business as Parke Health Center

  • Rural Health Clinic/Center
  • Burlington, CO
National Provider Identifier
1932211596
Registry record updated Feb 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
0905 Issued in CO
Legal business name
KIT CARSON COUNTY HEALTH SERVICES DISTRICT
Doing business as
Parke Health Center
Practice address
182 16TH St
Burlington, CO 80807-1649
Phone
(719) 346-9481
Fax
(719) 346-9485
NPI assigned
Aug 31, 2006
Last updated
Feb 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2021

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

Authorized official

Name
Brenda L Briegel
Title
Manager
Phone
(719) 346-9481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 0905 CO Primary

Addresses

Primary practice location

182 16TH St
Burlington, CO 80807-1649

Mailing address

182 16TH St
Burlington, CO 80807-1649
Phone (719) 346-9481

Other names 1

  • Parke Health Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040407001317 CO Part B Supplier - Clinic/Group Practice 4385637917 Receives reassigned benefits from 20 practitioners
Practice locations: Burlington, CO
O20080204000685 CO Part A Provider - Rural Health Clinic 4385637917 Practice locations: Burlington, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932211596. Details of each certification follow.

Rural health clinic certification: CCN 063997

Legal name
KIT CARSON COUNTY HEALTH SERVICES DISTRICT
Doing business as
PARKE HEALTH CENTER
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 25, 2000
Last certification
Nov 7, 2017
Ownership / control type
2B
Organization structure
GovernmentNon-profit
Enrollment address
182 16TH St
Burlington, CO 80807-1649

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory

Locations

182 16th St
Burlington, CO 80807
Phone (719) 346-4898

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
Brenda Briegel Individual Corporate DirectorManager Apr 13, 2016
W-2 Managing EmployeeManager Jan 1, 2000
Operational/Managerial ControlManager Aug 1, 2012 100%

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614038400000",
    "number": "1932211596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 16TH ST",
            "city": "BURLINGTON",
            "state": "CO",
            "postal_code": "808071649",
            "telephone_number": "719-346-9481",
            "fax_number": "719-346-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 16TH ST",
            "city": "BURLINGTON",
            "state": "CO",
            "postal_code": "808071649",
            "telephone_number": "719-346-9481",
            "fax_number": "719-346-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIT CARSON COUNTY HEALTH SERVICES DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-02-23",
        "certification_date": "2021-02-23",
        "status": "A",
        "authorized_official_last_name": "BRIEGEL",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "719-346-9481"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CO",
            "license": "0905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parke Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Parke Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlington, CO

Sources for this page

Verify at the official NPI Registry.