Individual provider Active NPI

Miriam Elaine Porter, AGACNP

  • Medical Oncology Physician
  • Springdale, AR
National Provider Identifier
1245631902
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
A004200 Issued in AR
Practice address
3901 Parkway Cir
Springdale, AR 72762-6362
Phone
(479) 587-1700
Fax
(479) 587-1366
NPI assigned
Sep 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X A004200 AR Primary

Addresses

Primary practice location

3901 Parkway Cir
Springdale, AR 72762-6362

Mailing address

2406 E Camelot PL
Fayetteville, AR 72701-2718

Other practice location 1

808 S 52nd St
Rogers, AR 72758-8602
Phone (479) 936-9900

Other practice location 2

3232 N Northhills Blvd
Fayetteville, AR 72703-4005
Phone (479) 587-1700

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)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1245631902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2406 E CAMELOT PL",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727012718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 PARKWAY CIR",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626362",
            "telephone_number": "479-587-1700",
            "fax_number": "479-587-1366"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 S 52nd St",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727588602",
            "country_code": "US",
            "telephone_number": "479-936-9900",
            "fax_number": "479-587-1366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3232 N Northhills Blvd",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727034005",
            "country_code": "US",
            "telephone_number": "479-587-1700",
            "fax_number": "479-587-1366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "MIRIAM",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "AR",
            "license": "A004200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.