Organization Active NPI

Portersville Family Practice PLLC

  • Nurse Practitioner
  • Portersville, PA
National Provider Identifier
1164939138
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
PORTERSVILLE FAMILY PRACTICE PLLC
Practice address
105 Adams Lane
Portersville, PA 16051
Phone
(724) 368-4118
Fax
(724) 368-4117
NPI assigned
Dec 29, 2017
Last updated
May 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Authorized official

Name
Cory R Wilhite, NPNPI 1316215064
Title
Owner
Phone
(724) 368-4118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary
Family Medicine Physician 207Q00000X NU

Addresses

Primary practice location

105 Adams Lane
Portersville, PA 16051

Mailing address

120 Adams LN
Portersville, PA 16051-2419
Phone (724) 368-4118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180403000330 PA Part B Supplier - Clinic/Group Practice 8729340765 Receives reassigned benefits from 3 practitioners
Practice locations: Portersville, PA

National Provider Directory

National Provider Directory

Locations

105 Adams Ln
Portersville, PA 16051
Phone (724) 368-4118

120 Adams Ln
Portersville, PA 16051
Phone (724) 368-4118

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652140800000",
    "number": "1164939138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 ADAMS LN",
            "city": "PORTERSVILLE",
            "state": "PA",
            "postal_code": "160512419",
            "telephone_number": "724-368-4118",
            "fax_number": "724-368-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ADAMS LANE",
            "city": "PORTERSVILLE",
            "state": "PA",
            "postal_code": "16051",
            "telephone_number": "724-368-4118",
            "fax_number": "724-368-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTERSVILLE FAMILY PRACTICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-29",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "WILHITE",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-368-4118",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portersville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.