Active NPI
Jeff Glen Porter, PT
- Physical Therapist
- Mobile, AL
National Provider Identifier
1255510681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTH4382
- Practice address
- 273 Azalea Rd
Mobile, AL 36609-1970 - Phone
- (251) 476-0192
- Fax
- (251) 479-1417
- NPI assigned
- Nov 1, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH4382 | AL | Primary |
Addresses
Primary practice location
273 Azalea Rd
Mobile, AL 36609-1970
Mailing address
273 Azalea Rd
Mobile, AL 36609-1970
Phone (251) 476-0192
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTH4382 | AL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193875200000",
"number": "1255510681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "273 AZALEA RD",
"city": "MOBILE",
"state": "AL",
"postal_code": "366091970",
"telephone_number": "251-476-0192",
"fax_number": "251-479-1417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "273 AZALEA RD",
"city": "MOBILE",
"state": "AL",
"postal_code": "366091970",
"telephone_number": "251-476-0192",
"fax_number": "251-479-1417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "JEFF",
"middle_name": "GLEN",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-01",
"last_updated": "2007-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH4382",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.