NPIMap

Organization Active NPI

Portercare Adventist Health System

Doing business as Southlands Breast Care & Therapy Center

  • General Acute Care Hospital
  • Aurora, CO
National Provider Identifier
1922648534
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
PORTERCARE ADVENTIST HEALTH SYSTEM
Doing business as
Southlands Breast Care & Therapy Center
Practice address
6069 S Southlands Pkwy
Aurora, CO 80016-5316
Phone
(303) 715-7000
NPI assigned
Jan 11, 2020
Last updated
Aug 9, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
PORTERCARE ADVENTIST HEALTH SYSTEMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Authorized official

Name
Matthew P Leary
Title
Group VP Finance
Phone
(303) 463-1022

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

6069 S Southlands Pkwy
Aurora, CO 80016-5316

Mailing address

PO Box 910317
Denver, CO 80291-0317
Phone (303) 715-7000

Other names 1

  • Southlands Breast Care & Therapy Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031024000017 CO Part A Provider - Hospital 0941110886 5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aurora, CO; Parker, CO

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922648534. Details of each certification follow.

Hospital certification: CCN 060114

Legal name
PORTERCARE ADVENTIST HEALTH SYSTEM
Doing business as
ADVENTHEALTH PARKER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Feb 12, 2004
Last certification
Dec 10, 2025
Beds
179
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Feb 20, 1930 in CO
Enrollment address
9395 Crown Crest Blvd
Parker, CO 80138-8573
Main/Primary Hospital Location
Hospital subgroups
General, Acute care

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
AdventHealth ParkerCCN 060114 · All quality measures
Overall star rating
5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Portercare Adventist Health System217 organizations share this tax ID, including this one
Part of
Portercare Adventist Health System

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

Ownership & related parties

All disclosed owners & managing parties 27

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gary Thurber Individual Corporate DirectorTrustee Aug 1, 2023
Jeremy Pittman Individual Corporate OfficerSecretary/Treasurer Apr 4, 2024
Darin Gottfried Individual Corporate DirectorDirector Jan 1, 2024
Brett Spenst Individual Corporate OfficerPresident/Asst Secretary Aug 1, 2023
Corporate DirectorTrustee Aug 1, 2023
Ryan Frazier Individual Corporate DirectorDirector Jul 1, 2023
Jeffrey Graff Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Chris J West Individual Corporate DirectorDirector Jul 1, 2016
Karsten Randolph Individual Corporate DirectorTrustee Aug 1, 2023
Ruby J Martinez Individual Corporate DirectorDirector Jan 1, 2023
Richard D'Ambrosio Individual Corporate OfficerAssistant Secretary Aug 24, 2023
Andrew D Jahn Individual Corporate OfficerVP/Chairperson Apr 1, 2024
Corporate DirectorTrustee Apr 1, 2024
John Thurber Individual Corporate DirectorTrustee Aug 1, 2023
Michael Saunders Individual Corporate OfficerAssistant Secretary Aug 24, 2023
Lars Houmann Individual Corporate DirectorTrustee Aug 1, 2023
Matthew Gal Individual Contracted Managing EmployeeCfo Jan 27, 2025
Corporate DirectorCfo Jan 27, 2025
Operational/Managerial ControlCfo Jan 27, 2025
Adventist Health System Sunbelt Healthcare Corporation Organization, Altamonte Springs, FL Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Oct 1, 2001 100%
Beth Martin Individual Corporate DirectorDirector Jan 1, 2018
Toni Berrios Individual Corporate OfficerAssistant Secretary Aug 24, 2023
Haney Vincent Individual Corporate OfficerAssistant Secretary Dec 9, 2021
David L Huffman Individual Corporate OfficerAssistant Secretary Aug 22, 2024
Robert C Foltz Individual Corporate OfficerAssistant Secretary Sep 11, 2014
Lynn Addiscott Individual Corporate OfficerAssistant Secretary Nov 10, 2005
Christopher Hillier Individual Corporate DirectorDirector Jul 1, 2016
Brian Taylor Individual Corporate DirectorDirector Jul 1, 2020
Marc Kristopher Ordelheide Individual Corporate DirectorTrustee Aug 1, 2023
Tim White Individual Corporate DirectorDirector Jan 1, 2018
Michael Goebel Individual Contracted Managing EmployeeChief Executive Officer Aug 1, 2023
Corporate DirectorEx-Officio Aug 1, 2023
Operational/Managerial ControlChief Executive Officer Aug 1, 2023

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 829

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 829

NPI Registry JSON

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

{
    "created_epoch": "1578700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1922648534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910317",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802910317",
            "telephone_number": "303-715-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6069 S SOUTHLANDS PKWY",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800165316",
            "telephone_number": "303-715-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PORTERCARE ADVENTIST HEALTH SYSTEM",
        "enumeration_date": "2020-01-11",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "LEARY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "GROUP VP FINANCE",
        "authorized_official_telephone_number": "303-463-1022"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southlands Breast Care & Therapy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.