Gregory Porter, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

00672 Issued in WV

Practice address

707 Chestnut St
South Charleston, WV 25309-2003

Phone

(304) 768-8500

Fax

(304) 768-8530

NPI assigned

Jan 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Spring Hill Primary Care Physicians PLLC

  • Internal Medicine Physician
  • South Charleston, WV
  • NPI 1306811781
  Medicare reassignment
• New Century Emergency Physician of West Virginia Inc

  • Emergency Medicine Physician
  • Charleston, WV
  • NPI 1396722641

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1053390450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CHESTNUT ST",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253092003",
            "telephone_number": "304-768-8500",
            "fax_number": "304-720-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 CHESTNUT ST",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253092003",
            "telephone_number": "304-768-8500",
            "fax_number": "304-768-8530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "GREGORY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "00672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV BCBS",
            "identifier": "001718067",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OH BWC",
            "identifier": "3000325",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Poage
• Shandia Poe
• Mark Pollard
• John Ponugupati, M.D.
• Bethany Harris Porter, AU.D.
• Robert Porter
• Salvador C. Portugal, M.D.
• Caitlin Dawn Poveromo
• Jaida Powell
• Melanie Powell

• Physician Assistant in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.