Lee W Porter, NP, CNS-PMH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202002489CNS-PP Issued in OR

Practice address

5305 River Rd N Ste B
Keizer, OR 97303-5324

Phone

(541) 896-1555

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 8

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clinicops LLC

  • Internal Medicine Physician
  • Florence, OR
  • NPI 1497251268
  NPD (past)
• Crystal River Psychiatric, GRP

  • Psychiatry Physician
  • Wilmington, NC
  • NPI 1003946047
  NPD (past)

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1013932425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 DIVISION AVE UNIT 299",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974042485",
            "telephone_number": "541-896-1555",
            "fax_number": "888-562-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 RIVER RD N STE B",
            "city": "KEIZER",
            "state": "OR",
            "postal_code": "973035324",
            "telephone_number": "541-896-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "LEE",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "NP, CNS-PMH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "OR",
            "license": "202002489CNS-PP",
            "primary": false
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "NC",
            "license": "163552",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "201501835NP-PP",
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201501835NP-PP",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "OR",
            "license": "202002489CNS-PP",
            "primary": false
        },
        {
            "code": "364SP0811X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Chronically Ill",
            "state": "OR",
            "license": "201501835NP-PP",
            "primary": false
        },
        {
            "code": "364SP0813X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Geropsychiatric",
            "state": "OR",
            "license": "202002489CNS-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202002489CNS-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PECOS PAC ID",
            "identifier": "3072541580",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PECOS PAC ENROLLMENT ID",
            "identifier": "I20160510002557",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER ID",
            "identifier": "131VX",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500709395",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian Phillips, PT, DPT
• Adelaide Anne Pierce
• Angela Pileggi, RPH
• Pinnacle Physical Therapy PC
• PNW Plastic Surgery LLC
• Benjamin Lawrence Porterfield, DC
• Melody Powell
• Powered by Motion Physical Therapy LLC
• Powered by Self Love Oregon LLC
• Victor Valentin Prati, P.T.

• Psychiatric/Mental Health Nurse Practitioner in Keizer, OR
• Providers in Keizer, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.