Timothy Ray Porter

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Practice address

1159 County Road 411
Proctorville, OH 45669-9409

Phone

(740) 861-9171

NPI assigned

Aug 16, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Daystar Services LLC

  • Adult Day Care Clinic/Center
  • Proctorville, OH
  • NPI 1174328991
  NPD Authorized official
• Cross Roads

  • Addiction (Substance Use Disorder) Counselor
  • Proctorville, OH
  • NPI 1336978071
  NPD

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1245062397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 COUNTY ROAD 411",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456699409",
            "telephone_number": "740-861-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 COUNTY ROAD 411",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456699409",
            "telephone_number": "740-861-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "TIMOTHY",
        "middle_name": "RAY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-16",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makenna R Palmer
• Jessica Michelle Perdue, FNP
• Ellen Ruth Phillips
• Kelly Jean Porter
• Micki Porter
• Veronica Renea Porter, PHARMD
• Premier Therapy & Health Centers, Inc.
• Proctorville Health Care, LLC
• Proctorville Health Care, LLC
• Proctorville Health Care, LLC

• Community/Behavioral Health Agency in Proctorville, OH
• Providers in Proctorville, OH by specialty
• Community/Behavioral Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.