Amanda Marie Johnston-Porter, CRPA-P

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

31 Thurber Dr
Waterloo, NY 13165-1665

Phone

(315) 539-1985

Fax

(315) 539-4393

NPI assigned

Sep 5, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1164071882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 FAYETTE ST",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651708",
            "telephone_number": "315-539-1957",
            "fax_number": "315-539-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 THURBER DR",
            "city": "WATERLOO",
            "state": "NY",
            "postal_code": "131651665",
            "telephone_number": "315-539-1985",
            "fax_number": "315-539-4393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON-PORTER",
        "first_name": "AMANDA",
        "middle_name": "MARIE",
        "credential": "CRPA-P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Banzer Jensen, SLP
• Kaila Jensen
• John Vernon Jetty, D.D.S.
• Courtney Johnson
• Trevor R Johnson
• Katrina Jones Galasik, MSN, APRN, PMHNP-BC
• Kristine Joslyn, LMSW
• Julie S. Bellone, PT, PLLC
• Kingsley D Kabari, STUDENT
• Steven L Kane, LCSW-R

• Peer Specialist in Waterloo, NY
• Providers in Waterloo, NY by specialty
• Peer Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2019; 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.