Active NPI
Portercare Adventist Health System
Doing business as Centura Health Physician Group Avista Neuroscience
- Neurological Surgery Physician
- Louisville, CO
National Provider Identifier
1851792097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- Legal business name
- PORTERCARE ADVENTIST HEALTH SYSTEM
- Doing business as
- Centura Health Physician Group Avista Neuroscience
- Practice address
- 80 Health Park Dr
Suite 50
Louisville, CO 80027-9584 - Phone
- (720) 321-8040
- Fax
- (720) 321-8041
- NPI assigned
- Sep 8, 2014
- Last updated
- Sep 25, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Angela Skinner
- Title
- Oma Administrator
- Phone
- (303) 643-0925
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | Primary |
Addresses
Primary practice location
80 Health Park Dr
Suite 50
Louisville, CO 80027-9584
Mailing address
PO Box 911244
Denver, CO 80291-1244
Phone (303) 643-1040
Other names 1
- Centura Health Physician Group Avista Neuroscience
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410134400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1443139200000",
"number": "1851792097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 911244",
"city": "DENVER",
"state": "CO",
"postal_code": "802911244",
"telephone_number": "303-643-1040",
"fax_number": "303-643-1176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 HEALTH PARK DR",
"address_2": "SUITE 50",
"city": "LOUISVILLE",
"state": "CO",
"postal_code": "800279584",
"telephone_number": "720-321-8040",
"fax_number": "720-321-8041"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
"organizational_subpart": "NO",
"enumeration_date": "2014-09-08",
"last_updated": "2015-09-25",
"status": "A",
"authorized_official_last_name": "SKINNER",
"authorized_official_first_name": "ANGELA",
"authorized_official_title_or_position": "OMA ADMINISTRATOR",
"authorized_official_telephone_number": "303-643-0925"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Centura Health Physician Group Avista Neuroscience",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Louisville, CO
- Portercare Adventist Health System (AdventHealth Medical Group Gastroenterology at Louisville)
- Portercare Adventist Health System (Avista Brain and Spine Institute)
- Portercare Adventist Health System
- Portercare Adventist Health System (Moav Med Onc Avista)
- Portercare Adventist Health System (AdventHealth Medical Group Orthopedic Surgery at Louisville)
- Portercare Adventist Health System (Adventhealth Avista)
- Portercare Adventist Health System (AdventHealth Medical Group Gynecologic Oncology at Louisville)
- Portercare Adventist Health System (Adventhealth Lab)
- Positive Therapeutic Beginnings, LLC
- Laureen O Powell, RDH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.