NPIMap

Individual provider Active NPI

Nicole Riebe Porro, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Charleston, SC
National Provider Identifier
1154559094
Registry record updated Oct 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
31761 Issued in SC
Practice address
165 Ashley Ave
Charleston, SC 29425-9125
Phone
(843) 876-7080
NPI assigned
Jun 30, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 31761 SC Primary

Addresses

Primary practice location

165 Ashley Ave
Charleston, SC 29425-9125

Mailing address

PO Box 741087
Atlanta, GA 30374-1087
Phone (843) 847-4179

Other names 1

  • Nicole Riebe Herring Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181016003865 SC Practitioner - Pathology 6204116247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical University of South Carolina College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charleston Pathology PAGroup PAC ID 4789640673, 13 clinicians

Practice addresses (Care Compare)

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2260

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31761SCMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Pathology PA Anatomic Pathology & Clinical Pathology Current Accepting new patients
Charleston Pathology PA Anatomic Pathology & Clinical Pathology Current Accepting new patients
Charleston Pathology PA Anatomic Pathology & Clinical Pathology Current Accepting new patients
Charleston Pathology, P.a. Anatomic Pathology & Clinical Pathology CurrentSince Feb 3, 2025 Accepting new patients
Charleston Pathology PA Anatomic Pathology & Clinical Pathology CurrentSince Feb 3, 2025 Accepting new patients
Dunes Pathology, LLC Anatomic Pathology & Clinical Pathology Current Accepting new patients
Clinical Laboratories of Hawaii LLP Past Accepting new patients

Locations

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

3500 N Highway 17
Mt Pleasant, SC 29466
Phone (843) 606-7000

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1154559094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741087",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741087",
            "telephone_number": "843-847-4179",
            "fax_number": "843-847-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294259125",
            "telephone_number": "843-876-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRO",
        "first_name": "NICOLE",
        "middle_name": "RIEBE",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "SC",
            "license": "31761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "HERRING",
            "middle_name": "RIEBE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.