Portercare Adventist Health System

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

PORTERCARE ADVENTIST HEALTH SYSTEM

Practice address

9695 S Yosemite St Ste 377
Lone Tree, CO 80124-2826

Phone

(720) 638-7500

Fax

(720) 484-6918

NPI assigned

Jun 15, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Angela J Skinner

Title

Administrator, Oma

Phone

(303) 673-7175

Specialties & licenses 1

Addresses

Other names 2

• NSCR NEUROSURG CRK Doing business as
• Neurosurgery One Castle Rock Other name

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 4

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

• Audrey Ryann Hemmings, DO

  • Obstetrics & Gynecology Physician
  • Louisville, CO
  • NPI 1043679103
  NPD
• Brandi Konecny, FNP-C

  • Nurse Practitioner
  • Lone Tree, CO
  • NPI 1174271746
  NPD
• Allison Whitney Spicer, PA-C

  • Physician Assistant
  • Englewood, CO
  • NPI 1417129123
  NPD
• Julianne Taylor, PA-C

  • Physician Assistant
  • Littleton, CO
  • NPI 1164815288
  NPD

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1508434663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801106",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801106",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9695 S YOSEMITE ST STE 377",
            "city": "LONE TREE",
            "state": "CO",
            "postal_code": "801242826",
            "telephone_number": "720-638-7500",
            "fax_number": "720-484-6918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR, OMA",
        "authorized_official_telephone_number": "303-673-7175",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NSCR NEUROSURG CRK",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Neurosurgery One Castle Rock",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• 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
• Portercare Adventist Health System

• Neurological Surgery Physician in Lone Tree, CO
• Providers in Lone Tree, CO by specialty
• Neurological Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.