Individual provider Active NPI

Carrie Freeman Porter, PHARMD

  • Pharmacist
  • Columbia, SC
National Provider Identifier
1053761825
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
8451 Issued in SC
Practice address
4464 Devine St
Columbia, SC 29205-3605
Phone
(803) 738-1108
Fax
(803) 738-7015
NPI assigned
Jun 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8451 SC Primary

Addresses

Primary practice location

4464 Devine St
Columbia, SC 29205-3605

Mailing address

4464 Devine St
Columbia, SC 29205-3605
Phone (803) 738-1108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
8451SCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1053761825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4464 DEVINE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292053605",
            "telephone_number": "803-738-1108",
            "fax_number": "803-738-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4464 DEVINE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292053605",
            "telephone_number": "803-738-1108",
            "fax_number": "803-738-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "CARRIE",
        "middle_name": "FREEMAN",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "8451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.