Portland Prescription Shop PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PORTLAND PRESCRIPTION SHOP PLLC

Practice address

705 S Broadway St
Portland, TN 37148-1628

Phone

(615) 323-5050

Fax

(615) 323-5052

NPI assigned

Sep 24, 2014

Last updated

Aug 24, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael E Stinnett, RPHNPI 1376752220

Title

Ceo

Phone

(270) 392-4248

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 2

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.

• Michael E Stinnett, RPH

  • Pharmacist
  • Portland, TN
  • NPI 1376752220
  NPD Authorized official
• Anthony Everhart, MD

  • Internal Medicine Physician
  • Kingsport, TN
  • NPI 1972505279
  NPD

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1043612880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 S BROADWAY ST",
            "address_2": "P.O. BOX 910",
            "city": "PORTLAND",
            "state": "TN",
            "postal_code": "371481628",
            "telephone_number": "615-323-5050",
            "fax_number": "615-323-5052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 S BROADWAY ST",
            "city": "PORTLAND",
            "state": "TN",
            "postal_code": "371481628",
            "telephone_number": "615-323-5050",
            "fax_number": "615-323-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND PRESCRIPTION SHOP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "STINNETT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "270-392-4248",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "5451",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Porter-Guyer, PA
• Paul R. Porter, M.D.
• Portland Clinic Pharmacy (Gallatin Prescription Shop)
• Portland Medical
• Portland Nursing & Rehab Center, Inc. (Highland Manor Nursing & Rehab Center)
• Portland Primary Care LLC
• Portland Primary Care, LLC
• Portland Surgical, LLC (Portland Surgical)
• Portland Wellness Center PLLC
• Precision Chiropractic of Portland

• Internal Medicine Physician in Portland, TN
• Providers in Portland, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.