NPIMap

Organization Active NPI

Porter Adventist Health System

Doing business as NSPK Neurosurg PKR

  • Neurological Surgery Physician
  • Parker, CO
National Provider Identifier
1669871612
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
PORTER ADVENTIST HEALTH SYSTEM
Doing business as
NSPK Neurosurg PKR
Practice address
9399 Crown Crest Blvd Ste 240
Parker, CO 80138-8571
Phone
(303) 649-3560
Fax
(303) 649-3561
NPI assigned
Aug 15, 2014
Last updated
Dec 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X NU Primary

Addresses

Primary practice location

9399 Crown Crest Blvd Ste 240
Parker, CO 80138-8571

Mailing address

PO Box 801106
Kansas City, MO 64180-1106
Phone (800) 953-0104

Other names 3

  • NSPK NEUROSURG PKR Doing business as
  • CHPG Neuro A Other name
  • CHPG Neuroscience & Spine Parker Other name

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

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1669871612",
    "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": "9399 CROWN CREST BLVD STE 240",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801388571",
            "telephone_number": "303-649-3560",
            "fax_number": "303-649-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTER ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-15",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "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": "",
            "desc": "Neurological Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NSPK NEUROSURG PKR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHPG Neuro A",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CHPG Neuroscience & Spine Parker",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "CHPG Neuroscience & Spine Parker",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 18, 2020; 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.