Individual provider Active NPI

Porcha Porter

  • Clinical Social Worker
  • Suffolk, VA
National Provider Identifier
1205405156
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904012814 Issued in VA
Practice address
3901 Breezeport Way Apt 105
Suffolk, VA 23435-1073
Phone
(757) 775-7381
NPI assigned
Jun 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904012814 VA Primary

Addresses

Primary practice location

3901 Breezeport Way Apt 105
Suffolk, VA 23435-1073

Mailing address

3901 Breezeport Way Apt 105
Suffolk, VA 23435-1073
Phone (216) 374-1015

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pporter@portsmouthva.gov

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

State licenses

LicenseStateTypeSpecialty
0904012814VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
City of Portsmouth CurrentSince Jun 1, 2021 Accepting new patients

Locations

1811 King St
Portsmouth, VA 23704
Phone (757) 393-5404

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": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1205405156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 BREEZEPORT WAY APT 105",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351073",
            "telephone_number": "216-374-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 BREEZEPORT WAY APT 105",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351073",
            "telephone_number": "757-775-7381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "PORCHA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904012814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pporter@portsmouthva.gov",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1811 King St",
            "city": "Portsmouth",
            "state": "VA",
            "country_code": "US",
            "postal_code": "237043032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.