Active NPI
Rose Mary Porter, CDA
- Dental Assistant
- Hampton, VA
National Provider Identifier
1407090699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- CE# 132766
- Practice address
- 100 Emancipation Dr
Hampton, VA 23667-0001 - Phone
- (757) 722-9961
- Fax
- (757) 728-3138
- NPI assigned
- May 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dental Assistant | 126800000X | CE# 132766 | VA | Primary |
Addresses
Primary practice location
100 Emancipation Dr
Hampton, VA 23667-0001
Mailing address
PO Box 1101
Franklin, VA 23851-1101
Phone (757) 653-4213
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 |
|---|---|---|---|
| CE# 132766 | VA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241136000000",
"number": "1407090699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1101",
"city": "FRANKLIN",
"state": "VA",
"postal_code": "238511101",
"telephone_number": "757-653-4213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 EMANCIPATION DR",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236670001",
"telephone_number": "757-722-9961",
"fax_number": "757-728-3138"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "ROSE",
"middle_name": "MARY",
"name_prefix": "Ms.",
"credential": "CDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-01",
"last_updated": "2009-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "VA",
"license": "CE# 132766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.