Individual provider Active NPI

Julie Kay Porter Kern, OD

  • Optometrist
  • Port Charlotte, FL
National Provider Identifier
1154431369
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC003041 Issued in FL
Practice address
1441 Tamiami TRL
Port Charlotte, FL 33948-1098
Phone
(941) 624-4600
Fax
(941) 624-6105
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC003041 FL Primary

Addresses

Primary practice location

1441 Tamiami TRL
Port Charlotte, FL 33948-1098

Mailing address

563 Park Estates Square
Venice, FL 34293
Phone (941) 408-0407

Other identifiers 1

IdentifierTypeStateIssuer
20789OtherFLBCBS

Other names 1

  • Julie Kay Porter Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091114000031 FL Practitioner - Optometry 9931247756 Practice locations: Port Charlotte, FL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1441 Tamiami TRL
Port Charlotte, FL 33948-1098
Phone (941) 624-4600

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC003041FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sarasota Retina Institute P a Past Accepting new patients

Organizations & group practices 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1154431369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "563 PARK ESTATES SQUARE",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "34293",
            "telephone_number": "941-408-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481098",
            "telephone_number": "941-624-4600",
            "fax_number": "941-624-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER KERN",
        "first_name": "JULIE",
        "middle_name": "KAY",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC003041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20789",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "PORTER",
            "middle_name": "KAY",
            "credential": "OD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.