Individual provider Active NPI

Veda Evette Porter, RMA, RPT, CNA, AHI

  • Home Health Aide
  • Jonesboro, GA
National Provider Identifier
1407198336
Registry record updated Mar 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
CN0000042636 Issued in GA
Practice address
1535 Interlaken Pass
Jonesboro, GA 30238-8033
Phone
(678) 830-3245
NPI assigned
Mar 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X CN0000042636 GA Primary

Addresses

Primary practice location

1535 Interlaken Pass
Jonesboro, GA 30238-8033

Mailing address

1535 Interlaken Pass
Jonesboro, GA 30238-8033
Phone (678) 830-3245

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
Credentials
Registered Medical Assistant

State licenses

LicenseStateTypeSpecialty
CN0000042636GAMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363564800000",
    "number": "1407198336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 INTERLAKEN PASS",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302388033",
            "telephone_number": "678-830-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 INTERLAKEN PASS",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302388033",
            "telephone_number": "678-830-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "VEDA",
        "middle_name": "EVETTE",
        "name_prefix": "Mrs.",
        "credential": "RMA, RPT, CNA, AHI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-18",
        "last_updated": "2013-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "GA",
            "license": "CN0000042636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2013; 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.