Individual provider Active NPI

Katelyn Porter

  • Psychiatric/Mental Health Nurse Practitioner
  • Dublin, OH
National Provider Identifier
1144059767
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2024058902 Issued in OH
Practice address
525 Metro PL N Ste 300
Dublin, OH 43017-5320
Phone
(855) 289-1722
NPI assigned
Jul 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2024058902 OH Primary

Addresses

Primary practice location

525 Metro PL N Ste 300
Dublin, OH 43017-5320

Mailing address

525 Metro PL N Ste 300
Dublin, OH 43017-5320
Phone (855) 289-1722

Other identifiers 1

IdentifierTypeStateIssuer
2910854MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241015002933 OH Practitioner - Nurse Practitioner 2264964238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Viaquest Psychiatric and Behavioral Solutions LLCGroup PAC ID 1153358486, 118 clinicians

Practice addresses (Care Compare)

525 Metro PL N
Suite 300
Dublin, OH 43017-5320
Phone (855) 289-1722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2024058902OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Viaquest Psychiatric & Behavioral Solutions LLC CurrentSince Jul 11, 2024 Accepting new patients
Viaquest Psychiatric & Behavioral Solutions LLC CurrentSince Jul 11, 2024 Accepting new patients

Locations

525 Metro Pl N
Ste 300
Dublin, OH 43017
Phone (614) 336-9600

Organizations & group practices 2

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": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1144059767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 300",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175320",
            "telephone_number": "855-289-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 300",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175320",
            "telephone_number": "855-289-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "KATELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "2024058902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

Verify at the official NPI Registry.