Wendy Carol Ports

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

00269213 Issued in NY

Practice address

243 W End Ave
Shirley, NY 11967-1606

Phone

(631) 772-4871

NPI assigned

Jul 17, 2007

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 17, 2007.

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1134328271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 W END AVE",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119671606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 W END AVE",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119671606",
            "telephone_number": "631-772-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTS",
        "first_name": "WENDY",
        "middle_name": "CAROL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "00269213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02670675",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Michelle Pluhowski
• Dominique Pocchia, BSN, RN
• Jessica Poelker
• Katherine Polchinski
• Frank Joseph Pollina, OPHTHALMIC DISPENSE
• Joseph William Primavera, PHARM D.
• Debra A Pure, CRPA
• Lalaine T Que, MD
• Sarala Radhakrishnan, M.D.
• Kaveh Rafiei, PHARM.D

• All providers in Shirley, NY
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.