Individual provider Active NPI

Samuel Ray Porterfield, LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1063981777
Registry record updated Nov 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14161 Issued in FL
Practice address
PFC Floyd K. Lindstrom Outpatient Clinic
3141 Centennial Blvd.
Colorado Springs, CO 80907
Phone
(719) 327-5660
NPI assigned
Nov 26, 2018
Last updated
Nov 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW14161 FL Primary

Addresses

Primary practice location

PFC Floyd K. Lindstrom Outpatient Clinic
3141 Centennial Blvd.
Colorado Springs, CO 80907

Mailing address

PFC Floyd K. Lindstrom Outpatient Clinic
3141 Centennial Blvd.
Colorado Springs, CO 80907
Phone (719) 327-5660

Other practice location 1

14 Oak Pl Uppr
Manitou Springs, CO 80829-2519
Phone (727) 735-4558

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

State licenses

LicenseStateTypeSpecialty
SW14161FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1063981777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PFC FLOYD K. LINDSTROM OUTPATIENT CLINIC",
            "address_2": "3141 CENTENNIAL BLVD.",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-327-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PFC FLOYD K. LINDSTROM OUTPATIENT CLINIC",
            "address_2": "3141 CENTENNIAL BLVD.",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-327-5660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14 Oak Pl Uppr",
            "address_purpose": "LOCATION",
            "city": "Manitou Springs",
            "state": "CO",
            "postal_code": "808292519",
            "country_code": "US",
            "telephone_number": "727-735-4558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTERFIELD",
        "first_name": "SAMUEL",
        "middle_name": "RAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.