SOUTHWEST COLORADO MENTAL HEALTH CENTER, INC (NPI# 1447630504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447630504 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST COLORADO MENTAL HEALTH CENTER, INC |
| Other Organization Name | CORTEZ INTEGRATED HEALTHCARE |
| Practice Address |
691 E Empire St Cortez CO 81321-2802 |
| Mailing Address |
Po Box 1328 Durango CO 81302-1328 |
| Practice Telephone | 9705657946 |
| Mailing Telephone | 9703352342 |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2020-11-03 |
| Authorized Official Name | SHELLY BURKE (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 0000000000 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHWEST COLORADO MENTAL HEALTH CENTER, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Axis Health System | Doing Business As Name - Organization |
| Cortez Integrated Healthcare | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487025060 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 216 Highway 172, Durango, CO 81303-8295 | 2015-10-08 |
| 1376827998 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 691 East Empire, Cortez, CO 81321 | 2011-09-30 |
| 1932192598 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 281 Sawyer Dr, Suite 100, Durango, CO 81303-3409 | 2005-08-29 |
| 1285255364 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 52 Village Dr, Pagosa Springs, CO 81147-8368 | 2020-04-30 |
| 1053931501 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 691 E Empire St, Cortez, CO 81321-2802 | 2020-04-24 |
| 1750901260 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 1125 Three Springs Blvd, Durango, CO 81301-9033 | 2020-04-24 |
| 1114547866 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 691 E Empire St, Cortez, CO 81321-2802 | 2020-04-23 |
| 1487274130 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 52 Village Dr, Pagosa Springs, CO 81147-8368 | 2020-04-23 |
| 1003436767 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 495 W 4th St, Dove Creek, CO 81324-4900 | 2020-04-23 |
| 1316567068 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 1970 E 3rd Ave, Durango, CO 81301-5056 | 2020-04-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | SOUTHWEST COLORADO MENTAL HEALTH CENTER, INC. | Axis Health System, 185 Suttle Street, Durango, CO 81303 |
| Street Address |
691 E EMPIRE ST |
| City | CORTEZ |
| State | CO |
| Zip Code | 81321-2802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407890916 | John R. Pearsall | Pediatrics | 691 E Empire St, Cortez, CO 81321-2802 | 2006-06-15 |
| 1053931501 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 691 E Empire St, Cortez, CO 81321-2802 | 2020-04-24 |
| 1114547866 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 691 E Empire St, Cortez, CO 81321-2802 | 2020-04-23 |
| 1669942041 | Kirstin Thoreen Howell | Nurse Practitioner | 691 E Empire St, Cortez, CO 81321-2802 | 2018-11-28 |
| 1104350164 | Eliza Gass | Dietitian, Registered | 691 E Empire St, Cortez, CO 81321-2802 | 2017-04-17 |
| 1356881841 | William Shanahan | Counselor | 691 E Empire St, Cortez, CO 81321-2802 | 2017-03-02 |
| 1750826780 | Mark Maness | Counselor | 691 E Empire St, Cortez, CO 81321-2802 | 2016-12-29 |
| 1558737353 | Anne Jones | Social Worker | 691 E Empire St, Cortez, CO 81321-2802 | 2015-08-15 |
| 1619364015 | Christine Amanda Koch | Family Medicine | 691 E Empire St, Cortez, CO 81321-2802 | 2015-04-23 |
| 1710383153 | Patricia Lynne Wilson | Counselor | 691 E Empire St, Cortez, CO 81321-2802 | 2014-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326667429 | Laurilyn Balfour Sturdevant | Dental Hygienist | 101 N Maple, Cortez, CO 81321 | 2020-04-09 |
| 1306231642 | Mesa View Retirement Home Inc. | Assisted Living Facility | 24760 County Road G, Cortez, CO 81321 | 2015-04-03 |
| 1528464765 | Patricia Nelson | Counselor | 691 E. Empire St., Cortez, CO 81321 | 2014-11-17 |
| 1417366808 | Summit Family Dental of Cortez, Pllc | Dentist | 111 S Sligo, Building A, Cortez, CO 81321 | 2014-08-11 |
| 1528480571 | Kelly Ogle | Registered Nurse | 17575 Road G, Cortez, CO 81321 | 2014-01-10 |
| 1316378821 | Beth A. Carter | Registered Nurse | 106 West North Street, Cortez, CO 81321 | 2013-12-09 |
| 1538596614 | Michael Daniel Grajeda | Physical Therapist | 111 N Park St Ste B, Cortez, CO 81321 | 2013-10-03 |
| 1275879876 | April L. Randle Md Inc | Internal Medicine | 215 Linden St, Suite D, Cortez, CO 81321 | 2012-12-31 |
| 1376827998 | Southwest Colorado Mental Health Center, Inc | Clinic/Center | 691 East Empire, Cortez, CO 81321 | 2011-09-30 |
| 1770879850 | Mark Holton | Marriage & Family Therapist | 1399 Cochita St, Cortez, CO 81321 | 2011-06-27 |
| Find all providers in zip 81321 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.