Patrick Da'Von Porter

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Practice address

4975 Duneville St Apt 325
Las Vegas, NV 89118-1272

Phone

(702) 417-4139

NPI assigned

Mar 14, 2020

Last updated

Mar 14, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1584144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584144000000",
    "number": "1023644630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4975 DUNEVILLE ST APT 325",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4975 DUNEVILLE ST APT 325",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891181272",
            "telephone_number": "702-417-4139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "PATRICK",
        "middle_name": "DA'VON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-14",
        "last_updated": "2020-03-14",
        "certification_date": "2020-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Porter
• Monica Porter
• Monica T Porter
• Octavia Porter
• Oli Porter
• Priscilla Regina Porter
• Quinte Porter
• Rochelle Porter
• Roseanne Ellen Porter
• Sebastian Porter

• Assisted Living Facility (Mental Illness) in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Assisted Living Facility (Mental Illness) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2020; 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.