Portercare Adventist Health System

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

PORTERCARE ADVENTIST HEALTH SYSTEM

Practice address

9399 Crown Crest Blvd
Suite 401
Parker, CO 80138-8506

Phone

(720) 274-2544

Fax

(720) 274-2541

NPI assigned

Jan 21, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David L Watson, M.D.

Title

C.M.O.

Phone

(303) 673-7181

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Colorado ENT Specialists Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Chechen Chu, M.D.

  • Family Medicine Physician
  • Castle Pines, CO
  • NPI 1649216136
  NPD
• Piper Lynn Rudel, FNP

  • Nurse Practitioner
  • Lone Tree, CO
  • NPI 1922298900
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461196800000",
    "number": "1104157775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911244",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802911244",
            "telephone_number": "303-643-1099",
            "fax_number": "303-643-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9399 CROWN CREST BLVD",
            "address_2": "SUITE 401",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388506",
            "telephone_number": "720-274-2544",
            "fax_number": "720-274-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2016-04-21",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "C.M.O.",
        "authorized_official_telephone_number": "303-673-7181",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80353568",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20422571",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colorado ENT Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paola Porrone, D.C.
• Porter Adventist Health System
• Porter Adventist Health System
• Portercare Adventist Health System
• Portercare Adventist Health System
• Portercare Adventist Health System
• Portercare Adventist Health System
• Portercare Adventist Health System
• Portercare Adventist Health System
• Portercare Adventist Health System

• Otolaryngology Physician in Parker, CO
• Providers in Parker, CO by specialty
• Otolaryngology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.