Brian Oscar Porter

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0101237244 Issued in VA

Practice address

12413 James Madison LN
Glenn Dale, MD 20769-9168

Phone

(804) 243-2136

NPI assigned

Apr 19, 2007

Last updated

Jul 8, 2007By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275750515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12413 JAMES MADISON LN",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699168",
            "telephone_number": "804-243-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12413 JAMES MADISON LN",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699168",
            "telephone_number": "804-243-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "BRIAN",
        "middle_name": "OSCAR",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101237244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vaul Anthony Phillips, M.D.
• PHS Family Medicine Glenn Dale
• PHS Glenn Dale
• Yvelore Pierre, RN
• Martin Edward Pinkett, R.PH
• Alphonsie Poumeni
• Pretty Pearls Pediatric Dentistry and Orthodontics, LLC (Scholastic Smiles Pediatric Dentistry Glenn Dale MD)
• Christina Price, ATC
• Prime Medicine LLC
• Prince Georges Kidney Care

• Internal Medicine Physician in Glenn Dale, MD
• Providers in Glenn Dale, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.