Active NPI
Madelyne Kaye Porter
- Massage Therapist
- South Ogden, UT
National Provider Identifier
1336790146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 9505343-4701
- Practice address
- 1893 E Skyline Dr Ste 204
South Ogden, UT 84403-5228 - Phone
- (801) 621-1667
- NPI assigned
- Sep 23, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 9505343-4701 | UT | Primary |
| Massage Therapist | 225700000X | 148704 | AK |
Addresses
Primary practice location
1893 E Skyline Dr Ste 204
South Ogden, UT 84403-5228
Mailing address
4339 S 2350 W
Roy, UT 84067-2013
Phone (757) 771-6783
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 |
|---|---|---|---|
| 148704 | AK | MD | Massage Therapist |
| 9505343-4701 | UT | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779926400000",
"number": "1336790146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4339 S 2350 W",
"city": "ROY",
"state": "UT",
"postal_code": "840672013",
"telephone_number": "757-771-6783"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1893 E SKYLINE DR STE 204",
"city": "SOUTH OGDEN",
"state": "UT",
"postal_code": "844035228",
"telephone_number": "801-621-1667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "MADELYNE",
"middle_name": "KAYE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-23",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "UT",
"license": "9505343-4701",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "AK",
"license": "148704",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in South Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.