Portercare Adventist Health System

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19871218588 Issued in CO

Legal business name

PORTERCARE ADVENTIST HEALTH SYSTEM

Practice address

10371 S. Parkglenn Way
Suite 230a
Parker, CO 80138

Phone

(303) 269-4333

Fax

(303) 220-5053

NPI assigned

Jun 23, 2008

Organization subpart

No

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

Authorized official

Name

David P Hesselink

Title

VP-Finance Pe

Phone

(303) 804-8136

Specialties & licenses 1

Addresses

Other names 1

• Willow Crest Health Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1144481102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 911244",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802911244",
            "telephone_number": "303-486-5401",
            "fax_number": "303-486-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10371 S. PARKGLENN WAY",
            "address_2": "SUITE 230A",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "80138",
            "telephone_number": "303-269-4333",
            "fax_number": "303-220-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "HESSELINK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "VP-FINANCE PE",
        "authorized_official_telephone_number": "303-804-8136"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "19871218588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Crest Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 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
• Portercare Adventist Health System
• Portercare Adventist Health System

• Family Medicine Physician in Parker, CO
• Providers in Parker, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; 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.