Organization Active NPI

Portercare Adventist Health System

Doing business as Change DBA to: Highlands Ranch Women's Care

  • Obstetrics & Gynecology Physician
  • Highlands Ranch, CO
National Provider Identifier
1780823740
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Doing business as
Change DBA to: Highlands Ranch Women's Care
Practice address
8671 S Quebec St
Suite 220
Highlands Ranch, CO 80130
Phone
(303) 346-4444
Fax
(303) 346-4411
NPI assigned
Feb 16, 2009
Last updated
Jun 17, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Authorized official

Name
Renae W Pemberton
Title
VP
Phone
(303) 804-8124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

8671 S Quebec St
Suite 220
Highlands Ranch, CO 80130

Mailing address

Dept 1244
Denver, CO 80291-0001
Phone (303) 486-5500

Other names 1

  • Change DBA to: Highlands Ranch Women's Care 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

Practitioners & affiliated clinicians

Practitioners 2

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": "1234742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1780823740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 1244",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802910001",
            "telephone_number": "303-486-5500",
            "fax_number": "303-486-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8671 S QUEBEC ST",
            "address_2": "SUITE 220",
            "city": "HIGHLANDS RANCH",
            "state": "CO",
            "postal_code": "80130",
            "telephone_number": "303-346-4444",
            "fax_number": "303-346-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-16",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "PEMBERTON",
        "authorized_official_first_name": "RENAE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "303-804-8124"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Change DBA to: Highlands Ranch Women's Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Highlands Ranch, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.