Portercare Adventist Health System

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PORTERCARE ADVENTIST HEALTH SYSTEM

Practice address

6081 South Quebec St.
Suite 110
Centennial, CO 80111

Phone

(303) 770-5600

Fax

(303) 770-2211

NPI assigned

Feb 3, 2012

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

• SOUTH QUEBEC FAMILY MEDICINE Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Locations

Practitioners 1

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

• Ryan Myers, M.D.

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1174840045
  NPD

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1326310558",
    "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": "303-347-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6081 SOUTH QUEBEC ST.",
            "address_2": "SUITE 110",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80111",
            "telephone_number": "303-770-5600",
            "fax_number": "303-770-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-03",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTH QUEBEC FAMILY MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Macie Joy Pope
• Corbin Kevin Popp, DMD
• Brandi Porter
• Innessa T Porter, MD
• Portercare Adventist Health System
• Portercare Adventist Health System
• Portercare Adventist Health System
• Portercare Adventist Health System
• Potomac Square Family Medicine, LLC
• Matthew Pott, PA

• Family Medicine Physician in Centennial, CO
• Providers in Centennial, 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.