Marvan Howard Porter, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT009830 Issued in GA

Practice address

495 Winn Way
Decatur, GA 30030-1736

Phone

(404) 389-0077

NPI assigned

Jan 12, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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.

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1134459209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6578 CHESTNUT OAKS RDG",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300384571",
            "telephone_number": "770-323-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301736",
            "telephone_number": "404-389-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "MARVAN",
        "middle_name": "HOWARD",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-12",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "116873",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kianna Porter-Simons
• Billie Jo Porter
• Carunda Porter
• Christina Jasmim Porter
• Janice Sue Porter, NP
• Sara Bradley Porter, MS RD LD
• Tameca Porter
• Kimberly Dionne Posey, MD
• Positive Directions Counseling & Behavioral Health Services, Inc.
• Positive Impact Health Centers, Inc.

• Physical Therapist in Decatur, GA
• Providers in Decatur, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.