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SAN LUIS VALLEYHEALTH MONTE VISTA COMMUNITY CLINIC
NPI 1083012504
Family Medicine in Monte Vista, CO

Active since December 16, 2014CLIA 06D2342653 · Microscopy
103 CHICO CT, MONTE VISTA, CO 81144(719) 852-9400(719) 852-9311 Get Directions Write a Review

NPPES record last updated: May 26, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 26, 2023, Nov 24, 2020 (2 updates tracked since 2020).

About San Luis Valleyhealth Monte Vista Community Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAN LUIS VALLEYHEALTH MONTE VISTA COMMUNITY CLINIC (NPI 1083012504) is a healthcare organization registered as a family medicine in Monte Vista, Colorado and active in the NPI registry since December 2014. The organization holds a CLIA Microscopy certificate valid through April 22, 2028 and lists Konni Martin, Ceo, as its authorized official.

NPPES Registry Identity

NPI1083012504
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Location Address103 CHICO CTMonte Vista, CO 81144-1065
Mailing Address106 Blanca AveAlamosa, CO 81101-2340 · (719) 589-2511 · Fax (719) 587-1372
Phone(719) 852-9400
Fax(719) 852-9311
Organization SubpartNo
Authorized OfficialKonni MartinCeo · (719) 587-1206
Enumeration DateDecember 16, 2014
Last NPPES UpdateMay 26, 20232 updates tracked since enumeration
NPPES CertifiedMay 26, 2023
✔ NPI 1083012504 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CO · 011001
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedChiropractorTaxonomy 111N00000X · License 011001 (CO)
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 011001 (CO)
Also ListedPhysician AssistantTaxonomy 363A00000X · License 011001 (CO)
103 CHICO CT, Monte Vista, CO 81144
Open in Google Maps ↗

Other Names 1

Doing Business AsSan Luis Valleyhealth Monte Vista Community Clinic

Other Identifiers 1

Medicaid9000144694CO

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 06D2342653

San Luis Valley Monte Vista Community Clinic · Monte Vista, CO
Active · expires Apr 22, 2028
CLIA Number06D2342653
Laboratory TypeRural Health Clinic
Certificate Effective DateApril 23, 2026
Certificate Expiration DateApril 22, 2028
Laboratory DirectorClint R. Sowards
Laboratory Phone(719) 852-9400
Laboratory LocationSan Luis Valley Monte Vista Community Clinic103 Chico Court, Monte Vista, CO 81144
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JACKIE DAWN BENNETT FNP-BC
Nurse Practitioner (Family)
103 CHICO CT
MONTE VISTA, CO 81144
Rio Grande County (719) 852-9400
LUTHERAN HOSPITAL ASSOCIATION OF THE SAN LUIS VALLEY
Orthopaedic Surgery
103 CHICO CT, SUITE B
MONTE VISTA, CO 81144
Rio Grande County (719) 852-7240
KENDRA COX PA-C
Physician Assistant
103 CHICO CT
MONTE VISTA, CO 81144
Rio Grande County (719) 852-9400
KYLE REED BARKDULL DO
Family Medicine
103 CHICO CT
MONTE VISTA, CO 81144
Rio Grande County (719) 852-9400
MONTE VISTA FAMILY PRACTICE
Family Medicine
103 CHICO CT
MONTE VISTA, CO 81144
Rio Grande County (719) 852-9400
DR. SUSANNAH REED CARY DO
Family Medicine
103 CHICO CT
MONTE VISTA, CO 81144
Rio Grande County (719) 852-9400
WILLIAM H COOPER MD
Psychiatry & Neurology (Neurology)
103 CHICO CT
MONTE VISTA, CO 81144
Rio Grande County (719) 852-9400
AMANDA L LEWIS PA-C
Physician Assistant
103 CHICO CT
MONTE VISTA, CO 81144
Rio Grande County (719) 852-9400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lutheran Hospital Association Of The San Luis Valley's NPI number?

The NPI number for Lutheran Hospital Association Of The San Luis Valley is 1083012504. It was assigned to this organization in the NPPES registry on December 16, 2014. The provider is doing business as San Luis Valleyhealth Monte Vista Community Clinic.

Where is Lutheran Hospital Association Of The San Luis Valley located?

Lutheran Hospital Association Of The San Luis Valley is located at 103 Chico Ct, Monte Vista, CO 81144. The listed phone number is (719) 852-9400.

What is Lutheran Hospital Association Of The San Luis Valley's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Lutheran Hospital Association Of The San Luis Valley hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 06D2342653) is associated with this NPI, valid through April 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lutheran Hospital Association Of The San Luis Valley was last updated on May 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.