Organization Active NPI

Portercare Adventist Health System

Doing business as Center for Endocrinology & Diabetes

  • Endocrinology, Diabetes & Metabolism Physician
  • Littleton, CO
National Provider Identifier
1881836906
Registry record updated Apr 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Doing business as
Center for Endocrinology & Diabetes
Practice address
7750 S Broadway
Suite 220
Littleton, CO 80122-2623
Phone
(720) 528-0860
Fax
(720) 528-0861
NPI assigned
Apr 3, 2009
Last updated
Apr 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2016

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

Authorized official

Name
David L Watson, M.D.
Title
C.M.O.
Phone
(303) 673-7181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary

Addresses

Primary practice location

7750 S Broadway
Suite 220
Littleton, CO 80122-2623

Mailing address

PO Box 911244
Denver, CO 80291-1244
Phone (303) 643-1099

Other identifiers 1

IdentifierTypeStateIssuer
46388362MedicaidCO

Other names 1

  • Center for Endocrinology & Diabetes 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 1

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": "1238716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1881836906",
    "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": "303-643-1099",
            "fax_number": "303-643-1176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7750 S BROADWAY",
            "address_2": "SUITE 220",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801222623",
            "telephone_number": "720-528-0860",
            "fax_number": "720-528-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-03",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "C.M.O.",
        "authorized_official_telephone_number": "303-673-7181",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46388362",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Endocrinology & Diabetes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; 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.