Nichole Porteus, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

12531 Issued in TX

Practice address

771 E Southlake Blvd Ste 103
Southlake, TX 76092-6354

Phone

(469) 369-7958

NPI assigned

Dec 18, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1326554056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 E LAMAR BLVD",
            "address_2": "APT 167",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76011",
            "telephone_number": "303-875-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 E SOUTHLAKE BLVD STE 103",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926354",
            "telephone_number": "469-369-7958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6103 Kenwood Ave",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752143015",
            "country_code": "US",
            "telephone_number": "469-369-7958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTEUS",
        "first_name": "NICHOLE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "TX",
            "license": "12531",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Polk
• Shiquvien Denise Polk
• Mary Maddie Pollok, AUD FAAA
• Kami Pope
• Jeremiah M Porter, PT, DPT
• Zachary Porto
• Janice Posey, BSN, RN
• Alayna Powers, NP
• Precision Orthopedics & Sports Medicine
• Precision Surgical Assist, L.L.C.

• Chiropractor in Southlake, TX
• Providers in Southlake, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.