Individual provider Active NPI

Melissa Hope Porter, P.A.-C.

  • Physician Assistant
  • Tallahassee, FL
National Provider Identifier
1124008602
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3765 Issued in GA
Practice address
2181 Orange Ave E
Tallahassee, FL 32311-6144
Phone
(850) 878-0191
Fax
(850) 706-3995
NPI assigned
Jan 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3765 GA Primary
Physician Assistant 363A00000X PA9113435 FL

Addresses

Primary practice location

2181 Orange Ave E
Tallahassee, FL 32311-6144

Mailing address

2181 Orange Ave E
Tallahassee, FL 32311-6144
Phone (850) 878-0191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200511000268 GA Practitioner - Physician Assistant 7214957471 Reassigns benefits to 1 organization
I20210205000842 FL Practitioner - Physician Assistant 7214957471 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9113435FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Colquitt Regional Medical Center CurrentSince Mar 1, 2020 Accepting new patients
Colquitt Regional Medical Center CurrentSince Mar 1, 2020 Accepting new patients
South Georgia Surgical Associates, PC Past Accepting new patients

Locations

3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1124008602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2181 ORANGE AVE E",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323116144",
            "telephone_number": "850-878-0191",
            "fax_number": "850-706-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2181 ORANGE AVE E",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323116144",
            "telephone_number": "850-878-0191",
            "fax_number": "850-706-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "MELISSA",
        "middle_name": "HOPE",
        "credential": "P.A.-C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "3765",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9113435",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.