Adria N Porter, OD
Individual provider Active NPI Optometrist · Providence, KY
NPI 1265429641 · NPPES record last updated Mar 2, 2018
Key facts
- NPI
- 1265429641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 1619-DT (KY)
- Practice address
- 215 E Main St
Providence, KY 42450-1261 - Phone
- (270) 667-7017
- Fax
- (270) 667-9065
- NPI assigned
- Sep 30, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- University Alabama Birmingham - School of Optometry, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
713 S Main St
Marion, KY 42064-1807
Phone (270) 965-5280
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 46 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040805000833 | KY | Practitioner - Optometry | 6608847280 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1619-DT | KY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marion Eye Care Center PLLC | Optometrist | Current |
Accepting new patients |
| The Ophthalmology Group, LLC | Optometrist | Past |
Accepting new patients |
| J Martin Lane Eyecare Center | Optometrist | Past |
Accepting new patients |
| Eyecare Center of Princeton PLLC | Optometrist | Past |
Accepting new patients |
Locations
713 S Main St
Marion, KY 42064
Phone (270) 965-4485
Interoperability endpoints
- aporter@marioneyecarecenter.eyefinity-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1619-DT | KY | Yes |
Addresses
Primary practice location
215 E Main St
Providence, KY 42450-1261
Mailing address
PO Box 37
Providence, KY 42450-0037
Phone (270) 667-7017
Other practice location 1
713 S Main St
Marion, KY 42064-1807
Phone (270) 965-5280
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77001212 | Medicaid | KY |
Other providers in Providence, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.