Organization · Type 2 NPI

Portercare Adventist Health System

Family Medicine Physician · Elizabeth, CO

NPI number 1003446485 Active

Practice location

240 Elizabeth St Ste B
Elizabeth, CO 80107-7546

Call (303) 269-2551 Map

Fax (303) 269-2552

Mailing address

PO Box 713425
Chicago, IL 60677-4325

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician Primary	207Q00000X	None listed

Family Medicine Physician: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Other family medicine physician providers in Elizabeth

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NPI record

NPI: 1003446485
Entity type: Organization (Type 2)
Issued: Jan 24, 2020
Last updated: Aug 14, 2026
Status: Active

Other names

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Adventhealth Medical Group Primary Care at Elizabeth · doing business as
Centura Medical Group Primary Care Elizabeth · other name

Authorized official

Mr. Jason Tacha
COO
(303) 304-7752

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1003446485

Portercare Adventist Health System's National Provider Identifier is 1003446485, issued on Jan 24, 2020. The primary taxonomy on file is Family Medicine Physician (207Q00000X), and the practice location is in Elizabeth, CO. The record was last updated on Aug 14, 2026.