Portercare Adventist Health System
Organization Active NPI Nurse Practitioner · Louisville, CO
NPI 1023974268 · NPPES record last updated Dec 31, 2025
Key facts
- NPI
- 1023974268
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- PORTERCARE ADVENTIST HEALTH SYSTEM
- Practice address
- 100 Health Park Dr
Louisville, CO 80027-9583 - Phone
- (303) 661-4346
- NPI assigned
- Dec 31, 2025
- Organization subpart
- No
Authorized official
- Name
- Jason Tacha
- Title
- Coo
- Phone
- (303) 304-7752
Corporate family (same tax ID) 15
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
100 Health Park Dr
Louisville, CO 80027-9583
Mailing address
PO Box 713425
Chicago, IL 60677-4325
Phone (800) 953-0104
Other names
- AdventHealth Medical Group Palliative Care at Avista
Other providers in Louisville, CO
- Paul Plocek
- Christopher Pohlman
- Erika Frances Poling
- Sabina Pomeroy
- Stefan Cristian Pop
- Portercare Adventist Health System
- Portercare Adventist Health System
- Portercare Adventist Health System
- Portercare Adventist Health System
- Portercare Adventist Health System
All providers in Louisville, CO · Nurse Practitioner 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 31, 2025. 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.