Porter Healthcare Solutions LLC

Organization Active NPI Adult Psychiatric/Mental Health Registered Nurse · Waycross, GA

NPI 1346010485 · NPPES record last updated Jan 8, 2024

Key facts

NPI: 1346010485
Entity type: Organization (NPI type 2)
Primary specialty: Adult Psychiatric/Mental Health Registered Nurse 163WP0809X
Legal business name: PORTER HEALTHCARE SOLUTIONS LLC
Practice address: 3085 Bentwood Dr
Waycross, GA 31503-4117
Phone: (912) 288-1024
NPI assigned: Jan 8, 2024
Organization subpart: No

Authorized official

Name: Mesiah Omar Porter Jr., APRN NPI 1134783368
Title: Owner
Phone: (912) 288-1024

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Mesiah O'Mar Porter Jr. Family Nurse Practitioner · Duluth, GA · NPI 1134783368

Medicare reassignment NPD Authorized official GA

Medicare participation

Medicare fee-for-service enrollment: Enrolled in GA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20250708002477	GA	Part B Supplier - Clinic/Group Practice	8325552870	Receives reassigned benefits from 1 practitioner Practice locations: Waycross, GA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Adult Psychiatric/Mental Health Registered Nurse Group: 193200000X MULTI-SPECIALTY GROUP	163WP0809X			Yes

Addresses

Primary practice location

3085 Bentwood Dr
Waycross, GA 31503-4117

Mailing address

3085 Bentwood Dr
Waycross, GA 31503-4117
Phone (912) 288-1024

Other providers in Waycross, GA

All providers in Waycross, GA · Adult Psychiatric/Mental Health Registered Nurse in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2024. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.