Portercare Adventist Health System
Organization Active NPI Orthopaedic Surgery of the Spine Physician · Haxtun, CO
NPI 1013526144 · NPPES record last updated Dec 21, 2020
Key facts
- NPI
- 1013526144
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery of the Spine Physician 207XS0117X
- Legal business name
- PORTERCARE ADVENTIST HEALTH SYSTEM
- Practice address
- 235 W Fletcher St
Haxtun, CO 80731-2737 - Phone
- (303) 925-4540
- Fax
- (303) 925-4541
- NPI assigned
- Jul 24, 2020
- Organization subpart
- No
Authorized official
- Name
- Mrs. Angela J Skinner
- Title
- Administrator- Oma
- Phone
- (303) 673-7175
Corporate family (same tax ID) 14
Practitioners 10
-
James H Edwards III, ACNP
-
Scott E Faulkner, M.D.
-
Oswaldo A Grenardo, MD, MBA, MS
-
Diane Light, MD
-
Robert C McClay, MD
-
Anna M Wegleitner, M.D.
-
Hafsa Aziz Bhatti, M.D.
-
Nicholas Osborn Palmeri, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090115000327 | CO | Part B Supplier - Clinic/Group Practice | 0941110886 |
Receives reassigned benefits from 869 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Avista Adventist Hospital
Locations
2535 S Downing St
Ste 460
Denver, CO 80210
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery of the Spine Physician |
207XS0117X | Yes |
Addresses
Primary practice location
235 W Fletcher St
Haxtun, CO 80731-2737
Mailing address
PO Box 801106
Kansas City, MO 64180-1106
Phone (800) 953-0104
Other names
- ORPC ORTHO HAXTUN
- CHPG Orthopedics and Sports Medicine Haxtun
- CHPG SPC Metro A
Other providers in Haxtun, CO
- Marianne Webb Apn RXN
- Ellen A McConnell
- Mindcare Solutions PC
- Northeast Boces
- Northeast Boces
- Prairie Vista Family Dental
- Tanner Reed
- Lila A Statz
- TMB Corporation
- Marianne E Webb
All providers in Haxtun, CO · Orthopaedic Surgery of the Spine Physician in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.