PEAK VISTA COMMUNITY HEALTH CENTERS (NPI# 1396048054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396048054 |
| Entity Type | Organization |
| Organization Name | PEAK VISTA COMMUNITY HEALTH CENTERS |
| Other Organization Name | LOGAN HEALTH CENTER AT MYRON STRATTON |
| Practice Address |
430 Gold Pass Heights Colorado Springs CO 80906 |
| Mailing Address |
3205 N Academy Blvd Suite 130 Colorado Springs CO 80917 |
| Practice Telephone | 7196325700 |
| Practice Fax Number | 7193447834 |
| Mailing Telephone | 7196325700 |
| Mailing Fax Number | 7193447865 |
| Enumeration Date | 2010-12-17 |
| Last Update Date | 2020-07-09 |
| Authorized Official Name | CHRISTI GARRIOTT (SENIOR VP OF BUSINESS INTELLIGENCE) |
| Authorized Official Telephone | 7193446454 |
| Is Organization Subpart | Y |
| Parent Organization Name | PEAK VISTA COMMUNITY HEALTH CENTERS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
CO | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 05638267 | 05 | |
| CO | 27870375 | 05 |
| Other Name | Type Code |
|---|---|
| Logan Health Center at Myron Stratton | Doing Business As Name - Organization |
| Logan Health Clinic at Myron Stratton | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912515735 | Peak Vista Community Health Centers | Clinic/Center | 423 E Cucharras St Ste 2, Colorado Springs, CO 80903-3609 | 2020-07-17 |
| 1639714041 | Peak Vista Community Health Centers | Clinic/Center | 4041 E San Miguel St, Colorado Springs, CO 80909 | 2019-11-08 |
| 1205255304 | Peak Vista Community Health Centers | Clinic/Center | 320 Commanche Street, Kiowa, CO 80117 | 2014-04-16 |
| 1851710065 | Peak Vista Community Health Centers | Clinic/Center | 55981 E Colfax Avenue, Strasburg, CO 80136 | 2014-04-15 |
| 1619224987 | Peak Vista Community Health Centers | Clinic/Center | 12050 Falcon Highway, Peyton, CO 80831 | 2012-08-06 |
| 1124320106 | Peak Vista Community Health Centers | Clinic/Center | 350 Lyckman Drive, Fountain, CO 80817 | 2010-11-24 |
| 1043512023 | Peak Vista Community Health Centers | Clinic/Center | 117 W Rio Grande Street, Colorado Springs, CO 80903 | 2010-11-24 |
| 1164752812 | Peak Vista Community Health Centers | Clinic/Center | 1740 Pepperwood Drive, Colorado Springs, CO 80910 | 2009-12-31 |
| 1497787535 | Peak Vista Community Health Centers | Clinic/Center | 2828 International Circle, Suite 100, Colorado Springs, CO 80910 | 2006-07-07 |
| 1700834272 | Peak Vista Community Health Centers | Pharmacy | 225 S Union, Garden Level, Colorado Springs, CO 80910 | 2006-05-05 |
| Street Address |
430 GOLD PASS HEIGHTS |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437797339 | Michael Crise | Behavior Technician | 1330 Qual Lake Loop Ste 120, Colorado Springs, CO 80906 | 2019-12-11 |
| 1730720541 | Amanda Salinas | Massage Therapist | 1235 Lake Plaza Drive Suite 230, Colorado Springs, CO 80906 | 2019-10-02 |
| 1225511488 | Sheila Meggison | Massage Therapist | 1235 Lake Plaza Drive, Suite 230, Colorado Springs, CA 80906 | 2018-09-12 |
| 1316429756 | Vivus Counseling Services LLC | Counselor | 108 East Cheyenne Rd Suite 201, Colorado Springs, CO 80906 | 2018-09-01 |
| 1043796949 | Erin Lee Recinos | Nurse Practitioner | 225 E Cheyenne Mountain Blvd Ste 220, Colorado Springs, CO 80906 | 2018-07-13 |
| 1982103875 | Savannah Adeline Rentrop | Behavior Technician | 2989 Broadmoor Valley Rd D, Colorado Springs, CO 80906 | 2018-02-06 |
| 1205335288 | Ross Knowlton | Behavior Technician | 1330 Quail Lake Loop Suite 200, Colorado Springs, CO 80906 | 2018-02-06 |
| 1942709845 | Adrienne Bohlen | Behavior Technician | 1330 Quail Lake Loop, Ste. 200, Colorado Springs, CO 80906 | 2018-02-06 |
| 1881110088 | Christine Gonzales | Nurse Practitioner | 2739 E Las Vegas St, Colorado Springs, CO 80906 | 2017-08-18 |
| 1225568470 | Larry Alwine | Counselor | 2860 South Circle Drive, Unit 250k, Colorado Springs, CO 80906 | 2017-06-19 |
| Find all providers in zip 80906 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912515735 | Peak Vista Community Health Centers | Clinic/Center | 423 E Cucharras St Ste 2, Colorado Springs, CO 80903-3609 | 2020-07-17 |
| 1639714041 | Peak Vista Community Health Centers | Clinic/Center | 4041 E San Miguel St, Colorado Springs, CO 80909 | 2019-11-08 |
| 1043512023 | Peak Vista Community Health Centers | Clinic/Center | 117 W Rio Grande Street, Colorado Springs, CO 80903 | 2010-11-24 |
| 1164752812 | Peak Vista Community Health Centers | Clinic/Center | 1740 Pepperwood Drive, Colorado Springs, CO 80910 | 2009-12-31 |
| 1720696578 | Peak Vista Community Health Centers | Clinic/Center | 3207 N Academy Blvd Ste 100, Colorado Springs, CO 80917-5117 | 2020-07-17 |
| 1437772365 | Peak Vista Community Health Centers | Clinic/Center | 5 W Las Vegas St, Colorado Springs, CO 80903-4217 | 2020-05-27 |
| 1437622206 | Peak Vista Community Health Centers | Clinic/Center | 1815 Jet Wing Dr, Colorado Springs, CO 80916-2300 | 2019-01-04 |
| 1194276105 | Peak Vista Community Health Centers | Clinic/Center | 340 Printers Pkwy, Colorado Springs, CO 80910 | 2016-10-14 |
| 1497198089 | Anna Dickey | Clinic/Center | 340 Printers Pkwy, Colorado Springs, CO 80910-3190 | 2013-04-12 |
| 1962740381 | Peak Vista Community Health Centers | Clinic/Center | 3207 N Academy Blvd, Suite 3500, Colorado Springs, CO 80917 | 2013-01-18 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80906 |
Please comment or provide details below to improve the information on PEAK VISTA COMMUNITY HEALTH CENTERS.
| 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.