NPIMap

Organization Active NPI

Salud Family Health

  • Federally Qualified Health Center (FQHC)
  • Frederick, CO
National Provider Identifier
1972636504
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
5995 Iris Pkwy
Frederick, CO 80504-6412
Phone
(303) 697-2583
Fax
(303) 833-6515
NPI assigned
Mar 13, 2007
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
Director of Finance and Accounint
Phone
(720) 322-9405

Specialties & licenses 1

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

Addresses

Primary practice location

5995 Iris Pkwy
Frederick, CO 80504-6412

Mailing address

203 S Rollie Ave
Fort Lupton, CO 80621-1508
Phone (303) 286-4560

Other identifiers 1

IdentifierTypeStateIssuer
60326522MedicaidCO

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
O20030612000052 CO Part A Provider - Federally Qualified Health Center (FQHC) 3173433398 Practice locations: Frederick, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972636504. Details of each certification follow.

Federally qualified health center certification: CCN 061809

Legal name
SALUD FAMILY HEALTH
Doing business as
SALUD FAMILY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 1, 1991
Last certification
Oct 1, 1991
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jun 21, 1971 in CO
Enrollment address
5995 Iris Pkwy
Frederick, CO 80504-6412

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

Locations

725 W Town and Country Rd
Ste 300
Orange, CA 92868

562 Sable Blvd
Ste 100
Aurora, CO 80011
Phone (720) 753-6000

Ownership & related parties

All disclosed owners & managing parties 6

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 Officer Jan 1, 1978
Jesus a Tijerina Individual Corporate Officer Jan 7, 1970
David Madsen Individual Operational/Managerial ControlCfo Jan 1, 2018
Linda E Hughes Individual Corporate Officer Jan 1, 1993
John Santistevan Individual Corporate Officer Sep 27, 1996
Joseph Daniel O'Connor Individual Corporate OfficerBilling Mar 13, 2018

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674604800000",
    "number": "1972636504",
    "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": "303-286-4560",
            "fax_number": "303-286-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5995 IRIS PKWY",
            "city": "FREDERICK",
            "state": "CO",
            "postal_code": "805046412",
            "telephone_number": "303-697-2583",
            "fax_number": "303-833-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALUD FAMILY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "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": "DIRECTOR OF FINANCE AND ACCOUNINT",
        "authorized_official_telephone_number": "720-322-9405"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60326522",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plan De Salud Del Valle Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Frederick, CO

Sources for this page

Verify at the official NPI Registry.