Individual provider Active NPI

Marcia Dianne Porter, RN

  • Registered Nurse
  • Ann Arbor, MI
National Provider Identifier
1114361383
Registry record updated Apr 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704287781 Issued in MI
Practice address
2140 E Ellsworth Rd
Ann Arbor, MI 48108-2552
Phone
(734) 222-3500
Fax
(734) 971-2487
NPI assigned
Apr 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704287781 MI Primary

Addresses

Primary practice location

2140 E Ellsworth Rd
Ann Arbor, MI 48108-2552

Mailing address

50224 Uptown Ave
Unit 202
Canton, MI 48187-4469
Phone (734) 657-2571

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704287781MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1114361383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50224 UPTOWN AVE",
            "address_2": "UNIT 202",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481874469",
            "telephone_number": "734-657-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2140 E ELLSWORTH RD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082552",
            "telephone_number": "734-222-3500",
            "fax_number": "734-971-2487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "MARCIA",
        "middle_name": "DIANNE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-18",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704287781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; 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.