Active NPI
Audrey Porter, M.D.
- Family Medicine Physician
- Urbandale, IA
National Provider Identifier
1174951560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 28835
- Practice address
- 2413 71St St
Urbandale, IA 50322-4862 - Phone
- (515) 278-9595
- Fax
- (515) 278-2329
- NPI assigned
- Oct 22, 2013
- Last updated
- Oct 22, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 28835 | IA | Primary |
Addresses
Primary practice location
2413 71St St
Urbandale, IA 50322-4862
Mailing address
2413 71St St
Urbandale, IA 50322-4862
Phone (515) 278-9595
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28835 | IA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1382400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1382400000000",
"number": "1174951560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2413 71ST ST",
"city": "URBANDALE",
"state": "IA",
"postal_code": "503224862",
"telephone_number": "515-278-9595",
"fax_number": "515-278-2329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2413 71ST ST",
"city": "URBANDALE",
"state": "IA",
"postal_code": "503224862",
"telephone_number": "515-278-9595",
"fax_number": "515-278-2329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "AUDREY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-22",
"last_updated": "2013-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "28835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Urbandale, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.