NPIMap

Organization Active NPI

Portercare Adventist Health System

Doing business as AdventHealth Medical Group Primary Care at Crystal Valley

  • Family Medicine Physician
  • Castle Rock, CO
National Provider Identifier
1730018565
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Doing business as
AdventHealth Medical Group Primary Care at Crystal Valley
Practice address
4141 Plum Creek Blvd Unit 200
Castle Rock, CO 80104-4130
Phone
(720) 455-8003
Fax
(720) 985-2087
NPI assigned
May 18, 2026
Last updated
May 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Authorized official

Name
Mr. Jason Tacha
Title
Coo
Phone
(303) 304-7752

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

4141 Plum Creek Blvd Unit 200
Castle Rock, CO 80104-4130

Mailing address

PO Box 713425
Chicago, IL 60677-4325
Phone (800) 953-0104

Other names 1

  • AdventHealth Medical Group Primary Care at Crystal Valley Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Portercare Adventist Health System216 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1779062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779062400000",
    "number": "1730018565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713425",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606774325",
            "telephone_number": "800-953-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 PLUM CREEK BLVD UNIT 200",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801044130",
            "telephone_number": "720-455-8003",
            "fax_number": "720-985-2087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-18",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A",
        "authorized_official_last_name": "TACHA",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "303-304-7752",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AdventHealth Medical Group Primary Care at Crystal Valley",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.