NPIMap

Organization Active NPI

Portercare Adventist Health System

Doing business as Bariatric & Metabolic Center of Colorado

  • Obesity Medicine (Internal Medicine) Physician
  • Parker, CO
National Provider Identifier
1174849624
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Doing business as
Bariatric & Metabolic Center of Colorado
Practice address
9397 Crown Crest Blvd
Suite 440
Parker, CO 80138-8575
Phone
(303) 269-4370
Fax
(303) 269-4371
NPI assigned
Apr 8, 2010
Last updated
Apr 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Authorized official

Name
Angela Skinner
Title
Oma Administrator
Phone
(303) 673-7175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Internal Medicine) Physician 207RB0002X NU Primary

Addresses

Primary practice location

9397 Crown Crest Blvd
Suite 440
Parker, CO 80138-8575

Mailing address

PO Box 911244
Denver, CO 80291-1244
Phone (303) 643-1099

Other identifiers 1

IdentifierTypeStateIssuer
90455568MedicaidCO

Other names 1

  • Bariatric & Metabolic Center of Colorado Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1174849624",
    "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": "9397 CROWN CREST BLVD",
            "address_2": "SUITE 440",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388575",
            "telephone_number": "303-269-4370",
            "fax_number": "303-269-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OMA ADMINISTRATOR",
        "authorized_official_telephone_number": "303-673-7175"
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90455568",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bariatric & Metabolic Center of Colorado",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.