Portia Monique Porter, CERTIFIED HAIR LOSS

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

7486 Creedmoor Rd
Raleigh, NC 27613-1663

Phone

(252) 544-4369

NPI assigned

Sep 21, 2021

Last updated

Sep 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1073284964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S GRACE ST",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278045602",
            "telephone_number": "252-407-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7486 CREEDMOOR RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276131663",
            "telephone_number": "252-544-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "PORTIA",
        "middle_name": "MONIQUE",
        "credential": "CERTIFIED HAIR LOSS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744R1102X",
            "taxonomy_group": "",
            "desc": "Specialist, Research Study",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1744P3200X",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Isaac William Porter, M.D.
• Kianna Porter, LCSWA
• Kristen Marleau Porter, LPC
• Laura Leigh Porter, NP
• Lindsay Porter, RN
• Robert James Porter, PA-C
• Wadeana Nicole Porter, M.ED., CCC-SLP
• Odalis Verenise Portillo
• Veronica Mary Portrait, MA ITFS
• Sally Marie Posey, PT

• Specialist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Specialist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.