ARKANSAS VALLEY REGIONAL MEDICAL CENTER (NPI# 1760489470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760489470 |
Entity Type | Organization |
Organization Name | ARKANSAS VALLEY REGIONAL MEDICAL CENTER |
Practice Address |
1100 Carson Ave La Junta CO 81050-2751 |
Practice Telephone | 7193836001 |
Practice Fax Number | 7193836005 |
Mailing Telephone | 7193836001 |
Mailing Fax Number | 7193836005 |
Enumeration Date | 2005-07-07 |
Last Update Date | 2017-02-16 |
Authorized Official Name | MR. FERRELL LYNN CROWELL (CEO) |
Authorized Official Telephone | 7193836000 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
16595 | CO | Allopathic & Osteopathic Physicians |
Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
010210 | CO | Hospitals |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CO | 05-021001 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609034206 | Arkansas Valley Regional Medical Center | Skilled Nursing Facility | 1100 Carson Avenue, La Junta, CO 81050 | 2008-05-30 |
1649449075 | Arkansas Valley Regional Medical Center | General Practice | 1100 Carson, La Junta, CO 81050-2751 | 2008-02-29 |
1609320514 | Arkansas Valley Regional Medical Center | Nurse Anesthetist, Certified Registered | 1100 Carson Ave, La Junta, CO 81050-2751 | 2016-08-09 |
1669747093 | Arkansas Valley Regional Medical Center | Pathology | 1100 Carson Ave, La Junta, CO 81050-2751 | 2012-03-19 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | ARKANSAS VALLEY REGIONAL MEDICAL CENTER | 1100 Carson Ave, La Junta, CO 81050-2751 |
Colorado Business Entities | ARKANSAS VALLEY REGIONAL MEDICAL CENTER | 1100 Carson Ave, La Junta, CO 81050 |
Street Address |
1100 CARSON AVE |
City | LA JUNTA |
State | CO |
Zip Code | 81050-2751 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144889916 | Amy Proctor | Physical Therapist | 1100 Carson Ave, La Junta, CO 81050-2751 | 2019-06-06 |
1609320514 | Arkansas Valley Regional Medical Center | Nurse Anesthetist, Certified Registered | 1100 Carson Ave, La Junta, CO 81050-2751 | 2016-08-09 |
1073961413 | Arkansas Valley Regional Medical Center Swing Bed | Medicare Defined Swing Bed Unit | 1100 Carson Ave, La Junta, CO 81050-2751 | 2016-05-26 |
1023414810 | Vickie Farnsworth | Pharmacist | 1100 Carson Ave, Dept of Pharmacy, La Junta, CO 81050-2751 | 2014-11-06 |
1275940496 | Kellie Logue | Nurse Anesthetist, Certified Registered | 1100 Carson Ave, La Junta, CO 81050-2751 | 2014-07-21 |
1629320239 | Michael Alvin Bergondo | Social Worker | 1100 Carson Ave, Suite 104, La Junta, CO 81050-2751 | 2012-10-05 |
1669747093 | Arkansas Valley Regional Medical Center | Pathology | 1100 Carson Ave, La Junta, CO 81050-2751 | 2012-03-19 |
1720238355 | Jessica Aaron Fief | Physical Therapy Assistant | 1100 Carson Ave, La Junta, CO 81050-2751 | 2008-09-18 |
1093964348 | Crystal Rose Thomas | Physical Therapist | 1100 Carson Ave, La Junta, CO 81050-2751 | 2008-09-11 |
1306002910 | Cyrena Kae Conlan | Occupational Therapist | 1100 Carson Ave, La Junta, CO 81050-2751 | 2008-08-03 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225658057 | Poudre Valley Medical Group, LLC | Internal Medicine | 2315 San Juan Avenue, La Junta, CO 81050 | 2020-04-22 |
1316589567 | Southeast Mental Health Services | Clinic/Center | 721 Barnes Ave, La Junta, CO 81050 | 2019-10-09 |
1164945127 | Susan Ann Workman | Clinical Nurse Specialist | 13 West Third Street, Room 111, La Junta, CO 81050 | 2017-07-21 |
1952774465 | Ryan T Anderson Ddc PC | Clinic/Center | 13 E 4th St., La Junta, CO 81050 | 2015-11-05 |
1083086524 | Ryan Taylor Anderson | Dentist | 13 East 4th Street, La Junta, CO 81050 | 2015-10-23 |
1902287329 | Shanna Kay Riley | Case Manager/Care Coordinator | 711 Barnes Ave., La Junta, CO 81050 | 2015-06-11 |
1548668593 | Joseph Wayne Lee | Licensed Practical Nurse | 1203 Holt Ln, Lajunta, CO 81050 | 2014-12-08 |
1730506809 | Down To Earth Dentistry, LLC. | Dentist | 17 W. 4th St., La Junta, CO 81050 | 2014-03-26 |
1154668275 | Arkansas Valley Hearing Center, Inc | Hearing Aid Equipment | 408 West 3rd St, La Junta, CO 81050 | 2013-01-09 |
1710223698 | Timothy Eugene Kelley | Counselor | 313 West Third Street, Suite 204, La Junta, CO 81050 | 2012-12-20 |
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Taxonomy Code | 282NC0060X |
Grouping | Hospitals |
Classification | General Acute Care Hospital |
Specialization | Critical Access |
Definition to come. |
Notes: [7/1/2003: new] |
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1790983872 | Greg A Stransky | General Acute Care Hospital | 6365 W 45th Pl, Wheat Ridge, CO 80033-3730 | 2007-07-10 |
1366452732 | County of Kiowa Hospital District | General Acute Care Hospital | 1208 Luther Street, Eads, CO 81036 | 2006-08-09 |
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1174557763 | Amy Wehrman | General Acute Care Hospital | 19269 W 53rd Loop, Golden, CO 80403-2161 | 2006-07-10 |
1891733879 | East Phillips County Hospital District | General Acute Care Hospital | 1001 E Johnson Street, Holyoke, CO 80734-1854 | 2006-06-03 |
1497710958 | St. Vincent General Hospital District | General Acute Care Hospital | 822 W 4th Street, Leadville, CO 80461 | 2006-04-19 |
1407811961 | St. Vincent General Hospital District | General Acute Care Hospital | 822 W. 4th Street, Leadville, CO 80461-3897 | 2006-04-19 |
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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.