Active NPI
John Kevin Porter
- Clinical Social Worker
- Mather, CA
National Provider Identifier
1336722206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 198010
- Practice address
- 10535 Hospital Way
Mather, CA 95655-4200 - Phone
- (916) 843-9166
- NPI assigned
- Apr 29, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 198010 | CA | Primary |
Addresses
Primary practice location
10535 Hospital Way
Mather, CA 95655-4200
Mailing address
10535 Hospital Way
Mather, CA 95655-4200
Phone (916) 843-9166
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | john.porter1@va.gov |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 198010 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619654400000",
"number": "1336722206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10535 HOSPITAL WAY",
"city": "MATHER",
"state": "CA",
"postal_code": "956554200",
"telephone_number": "916-843-9166"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10535 HOSPITAL WAY",
"city": "MATHER",
"state": "CA",
"postal_code": "956554200",
"telephone_number": "916-843-9166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "JOHN",
"middle_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-29",
"last_updated": "2021-04-29",
"certification_date": "2021-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "198010",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "john.porter1@va.gov",
"affiliation": "N",
"endpointDescription": "email",
"address_1": "10535 Hospital Way",
"city": "Mather",
"state": "CA",
"country_code": "US",
"postal_code": "956554200",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Mather, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.