David Michael Portner, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810001188 Issued in VA

Practice address

1428 Water Mill Cir
Virginia Beach, VA 23454-1359

Phone

(757) 642-2567

Fax

(757) 233-0201

NPI assigned

Sep 20, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• David M Portner, PH.D. PLC

  • Clinical Psychologist
  • Virginia Beach, VA
  • NPI 1699215970
  NPD Authorized official

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278806400000",
    "number": "1063510238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 WATER MILL CIR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234541359",
            "telephone_number": "757-642-2567",
            "fax_number": "757-233-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 WATER MILL CIR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234541359",
            "telephone_number": "757-642-2567",
            "fax_number": "757-233-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTNER",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007704232",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007704224",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007705557",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dedra Porter
• La'Nya Porter
• Leora Lawrence Porter, LCSW
• Taylor Porter
• Jake Portillo, MD
• Mary Portner
• Positive Behavioral Supports of Virginia
• Cassandra Paige Possehl
• Post Treatment Homes, Inc.
• Billy Bryan Post, LCSW

• Clinical Psychologist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2010; 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.