Individual provider Active NPI

Joshua Porter, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Chattanooga, TN
National Provider Identifier
1265714299
Registry record updated Aug 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3344 Issued in TN
Practice address
979 E 3Rd St Ste C225
Chattanooga, TN 37403-3314
Phone
(423) 778-5995
Fax
(423) 778-5994
NPI assigned
Sep 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3344 TN Primary

Addresses

Primary practice location

979 E 3Rd St Ste C225
Chattanooga, TN 37403-3314

Mailing address

975 E. Third Street
Attn: Provider Enrollment
Chattanooga, TN 37403-3314
Phone (423) 778-5995

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171104000069 TN Practitioner - Physician Assistant 7911179072 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3344TNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Hamilton County Hospital Authority CurrentSince Aug 28, 2017 Accepting new patients
Chattanooga Hamilton County Hospital Authority CurrentSince Aug 28, 2017 Accepting new patients

Locations

979 E 3rd St
Ste C225
Chattanooga, TN 37403
Phone (423) 778-5995

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

9400 Rhea County Hwy
Dayton, TN 37321
Phone (423) 285-5220

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1316044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502236800000",
    "number": "1265714299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 E. THIRD STREET",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374033314",
            "telephone_number": "423-778-5995",
            "fax_number": "423-778-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST STE C225",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374033314",
            "telephone_number": "423-778-5995",
            "fax_number": "423-778-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JOSHUA",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-15",
        "last_updated": "2017-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.