Individual provider Active NPI

Daniel D Porter, D.C.

  • Chiropractor
  • Lakeland, MN
National Provider Identifier
1225200439
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2473 Issued in MN
Practice address
326 Saint Croix Trail South
Lakeland, MN 55043-0294
Phone
(651) 436-7724
Fax
(651) 436-7724
NPI assigned
Mar 27, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2473 MN Primary

Addresses

Primary practice location

326 Saint Croix Trail South
Lakeland, MN 55043-0294

Mailing address

PO Box 294
Lakeland, MN 55043-0294
Phone (651) 436-7724

Other identifiers 1

IdentifierTypeStateIssuer
4C786LAOtherMNBCBSM

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2473MNMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206576000000",
    "number": "1225200439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 294",
            "city": "LAKELAND",
            "state": "MN",
            "postal_code": "550430294",
            "telephone_number": "651-436-7724",
            "fax_number": "651-436-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 SAINT CROIX TRAIL SOUTH",
            "city": "LAKELAND",
            "state": "MN",
            "postal_code": "550430294",
            "telephone_number": "651-436-7724",
            "fax_number": "651-436-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "DANIEL",
        "middle_name": "D",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "2473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "4C786LA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.