Jeremy Choummany Porter, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

MD186508 Issued in OR

Practice address

707 SW Washington St Ste 700
Portland, OR 97205

Phone

(503) 299-9906

Fax

(503) 225-9002

NPI assigned

Mar 27, 2014

Last updated

Oct 18, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oag Trauma Services LLC

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1548669948
  NPD (past)

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1255758207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35147",
            "address_2": "#1801",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245147",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SW WASHINGTON ST STE 700",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97205",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JEREMY",
        "middle_name": "CHOUMMANY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-27",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD186508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500745613",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Lynn Porter, QMHA
• Chloe S Porter, PAC
• David W Porter, MD
• Greg P Porter, BA
• Holly Porter, RD
• Kelsey Porter
• Kimberly Terrele Porter, MSW
• Kirk I. Porter, LCSW
• Linda S Porter, RN
• Lisa Mary Porter, OT

• Anesthesiology Physician in Portland, OR
• Providers in Portland, OR by specialty
• Anesthesiology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; 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.