| Contacts | Authorizing Official | Update | AO Change Request | Sobczak, Gene
Interim CEO
High Plains Community Health Center
7193360261 | Reed, Claire H.
Interim CEO
High Plains Community Health Center
7193360261-7193360261 | 3/14/2025 10:41 AM |
| Contacts | Primary Contact | Update | AO Change Request | PARKER, BETH
COMPLIANCE OFFICER
High Plains Community Health Center
7193360261-151 | Carroll, Jeremy H.
CFO
High Plains Community Health Center
7193360261-7193360261 | 3/14/2025 10:41 AM |
| Details | Last Recertification Date | Update | Recertification | 2/6/2024 4:17:18 PM | 2/25/2025 2:31:33 PM | 2/25/2025 2:31 PM |
| Details | Last Recertification Date | Update | Recertification | 2/8/2023 10:12:55 AM | 2/6/2024 4:17:18 PM | 2/6/2024 4:17 PM |
| Contacts | Authorizing Official | Update | Change Request | emick, shae lynne
Chief Operations Officer
High Plains Community Health Center
7193360261-1146 | Sobczak, Gene
Interim CEO
High Plains Community Health Center
7193360261 | 2/27/2023 11:09 AM |
| Details | Last Recertification Date | Update | Recertification | 2/22/2022 1:05:10 PM | 2/8/2023 10:12:55 AM | 2/8/2023 10:12 AM |
| Contacts | Authorizing Official | Update | Profile Change Request | emick, shae lynne
CEO- Interim
High Plains Community Health Center
7193360261-1146 | emick, shae lynne
Chief Operations Officer
High Plains Community Health Center
7193360261-1146 | 7/1/2022 6:17 AM |
| Details | Last Recertification Date | Update | Recertification | 2/18/2021 1:15:51 PM | 2/22/2022 1:05:10 PM | 2/22/2022 1:05 PM |
| Contacts | Authorizing Official | Update | OPA Edit | NIEMEYER, ERIC
CEO
High Plains Community Health Center
7193360261-120 | emick, shae lynne
CEO- Interim
High Plains Community Health Center
7193360261-1146 | 2/22/2022 12:24 PM |
| Medicaid Billing | NPI: Number | Delete | Recertification | 1609240894 ( ) | | 2/18/2021 1:15 PM |
| Medicaid Billing | NPI: Number | Delete | Recertification | 1043592850 ( ) | | 2/18/2021 1:15 PM |
| Medicaid Billing | NPI: Number | Insert | Recertification | | 1043592850 | 2/18/2021 1:15 PM |
| Medicaid Billing | NPI: State | Insert | Recertification | | CO | 2/18/2021 1:15 PM |
| Medicaid Billing | NPI: Number | Insert | Recertification | | 1609240894 | 2/18/2021 1:15 PM |
| Medicaid Billing | NPI: State | Insert | Recertification | | CO | 2/18/2021 1:15 PM |
| Details | Last Recertification Date | Update | Recertification | 2/12/2020 5:24:06 PM | 2/18/2021 1:15:51 PM | 2/18/2021 1:15 PM |
| Details | Last Recertification Date | Update | Recertification | 2/19/2019 7:42:51 AM | 2/12/2020 5:24:06 PM | 2/12/2020 5:24 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | Change Request | | False | 3/15/2019 12:17 PM |
| Medicaid Billing | Medicaid: Number | Insert | Change Request | | 9000148041 | 3/15/2019 12:17 PM |
| Medicaid Billing | Medicaid: State | Insert | Change Request | | CO | 3/15/2019 12:17 PM |
| Medicaid Billing | NPI: Number | Insert | Change Request | | 1609240894 | 3/15/2019 12:17 PM |
| Details | Last Recertification Date | Update | Recertification | 2/23/2018 1:59:51 PM | 2/19/2019 7:42:51 AM | 2/19/2019 7:42 AM |
| Details | Entity Subname | Update | Recertification | HIGH PLAINS CH DENTAL CLINIC | Family Health Center | 2/19/2019 7:42 AM |
| Details | Last Recertification Date | Update | Recertification | 2/6/2017 12:00:00 AM | 2/23/2018 1:59:51 PM | 2/23/2018 1:59 PM |
| Contacts | Authorizing Official | Update | | NIEMEYER, ERIC
CEO
7193360261-120 | NIEMEYER, ERIC
CEO
High Plains Community Health Center
7193360261-120 | 10/16/2017 5:27 PM |
| Contacts | Primary Contact | Update | | PARKER, BETH
COMPLIANCE OFFICER
7193360261-151 | PARKER, BETH
COMPLIANCE OFFICER
High Plains Community Health Center
7193360261-151 | 10/16/2017 5:19 PM |
| Contacts | Authorizing Official | Insert | | | NIEMEYER, ERIC
CEO
7193360261-120 | 7/20/2017 4:41 PM |
| Contacts | Primary Contact | Insert | | | PARKER, BETH
COMPLIANCE OFFICER
7193360261-151 | 2/6/2017 2:27 PM |
| Addresses | Main Address | Insert | | |
200 Kendall Dr
Lamar, CO 81052-3940 | 2/6/2017 2:26 PM |
| Details | Last Recertification Date | Update | | 2/12/2016 12:00:00 AM | 2/6/2017 12:00:00 AM | 2/6/2017 2:26 PM |
| Details | Last Recertification Date | Update | | 1/28/2015 12:00:00 AM | 2/12/2016 12:00:00 AM | 2/12/2016 11:14 AM |
| Details | Last Recertification Date | Update | | 3/17/2014 12:00:00 AM | 1/28/2015 12:00:00 AM | 1/28/2015 2:56 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | | | False | 3/17/2014 8:33 PM |
| Medicaid Billing | Medicaid: Number | Insert | | | 59258063 | 3/17/2014 8:33 PM |
| Medicaid Billing | Medicaid: State | Insert | | | CO | 3/17/2014 8:33 PM |
| Medicaid Billing | NPI: Number | Insert | | | 1043592850 | 3/17/2014 8:33 PM |
| Details | Last Recertification Date | Update | | 4/1/2013 12:00:00 AM | 3/17/2014 12:00:00 AM | 3/17/2014 8:33 PM |
| Details | Entity Subname | Update | | HIGH PLAINS COMMUNITY HEALTH DENTAL CENTER | HIGH PLAINS CH DENTAL CLINIC | 3/17/2014 8:33 PM |
| Details | Last Recertification Date | Update | | | 4/1/2013 12:00:00 AM | 2/14/2013 3:04 PM |
| Addresses | Billing Address | Insert | | | HIGH PLAINS COMMUNITY HEALTH CENTER
201 KENDALL DRIVE
LAMAR, CO 81052 | 1/3/2013 1:45 PM |
| Addresses | Shipping Address | Insert | | | HIGH PLAINS COMMUNITY HEALTH CENTER
201 KENDALL DRIVE
LAMAR, CO 81052 | 8/12/2005 10:24 AM |
| Details | Last Recertification Date | Insert | | | | 8/12/2005 10:24 AM |
| Details | Grant Number | Insert | | | H80CS00214 | 8/12/2005 10:24 AM |
| Details | 340B ID | Insert | | | CH08410A | 8/12/2005 10:24 AM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 8/12/2005 10:24 AM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 8/12/2005 10:24 AM |
| Details | Medicare Provider Number | Insert | | | | 8/12/2005 10:24 AM |
| Details | Entity Name | Insert | | | HIGH PLAINS COMMUNITY HEALTH CENTER | 8/12/2005 10:24 AM |
| Details | Program Code | Insert | | | CH | 8/12/2005 10:24 AM |
| Details | Entity Subname | Insert | | | HIGH PLAINS COMMUNITY HEALTH DENTAL CENTER | 8/12/2005 10:24 AM |
| Dates | Participating Approval Date | Insert | | | 1/24/2005 12:00:00 AM | 8/12/2005 10:24 AM |
| Details | State | Insert | | | Active | 8/12/2005 10:24 AM |
| Dates | Registration Date | Insert | | | 4/1/2005 12:00:00 AM | 8/12/2005 10:24 AM |
| Dates | Signed By Date | Insert | | | | 8/12/2005 10:24 AM |
| Dates | Start Date | Insert | | | 4/1/2005 12:00:00 AM | 8/12/2005 10:24 AM |
| Terminations | Termination Comments | Insert | | | | 8/12/2005 10:24 AM |
| Terminations | Termination Date | Insert | | | | 8/12/2005 10:24 AM |
| Terminations | Termination Effective Date | Insert | | | | 8/12/2005 10:24 AM |
| Terminations | Termination Reason | Insert | | | | 8/12/2005 10:24 AM |
| Details | Comments Public | Insert | | | NEW SITE 4/01/05 | 8/12/2005 10:24 AM |