Jennifer Porter, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2107 Issued in AR

Practice address

155 S Adams Ave
Camden, AR 71701-4031

Phone

(870) 498-4357

NPI assigned

Oct 1, 2007

Sex

Female

Sole proprietor

No

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

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.

• Kah Development 4, LLC

  • Home Health Agency
  • Camden, AR
  • NPI 1710337738
  NPD (past)
• State of Arkansas

  • Home Health Agency
  • Harrison, AR
  • NPI 1235150087
  NPD (past)

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1053508358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 WOODWARD",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532132",
            "telephone_number": "870-904-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 S ADAMS AVE",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717014031",
            "telephone_number": "870-498-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JENNIFER",
        "name_prefix": "Miss",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AR",
            "license": "2107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pinnacle Hearing LLC
• Charles G Pope, OD
• Charles Wilson Pope, O.D.
• Leah Pope, RDH
• Barbara Ann Porchia, DPM
• Premise Health of Arkansas Medical P a
• Prime Medical Group PLLC
• Christi Deann Proffitt, APRN
• Montril Charles Rabion
• Elizabeth Ray

• Physical Therapy Assistant in Camden, AR
• Providers in Camden, AR by specialty
• Physical Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.