NPIMap

Individual provider Active NPI

Amanda Corey Porter, PSY.D

  • Psychologist
  • Northfield, MN
National Provider Identifier
1447217138
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP5356 Issued in MN
Practice address
1400 Jefferson Rd
Northfield, MN 55057-3081
Phone
(651) 241-0775
Fax
(651) 241-0772
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2007030012 MO
Psychologist 103T00000X LP5356 MN Primary

Addresses

Primary practice location

1400 Jefferson Rd
Northfield, MN 55057-3081

Mailing address

1400 Jefferson Rd
Northfield, MN 55057-3081
Phone (651) 241-0775

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aporter162378@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110628000083 MN Practitioner - Clinical Psychologist 0446388391 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Allina Health SystemGroup PAC ID 4587573613, shared by 89 NPIs, 3,844 clinicians

Practice addresses (Care Compare)

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

Merit-based Incentive Payment System (MIPS)

Final score
85.6 of 100Reported as group
Quality
72.5
Promoting interoperability
100
Improvement activities
40
Cost
77.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince May 18, 2011 Accepting new patients
Allina Health System CurrentSince May 18, 2011 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Dec 31, 2022 Accepting new patients
Allina Health System Current Accepting new patients
Allied Mental Health Consultants LLC PastSince Aug 18, 2015 Accepting new patients
Allied Mental Health Associates, Inc. Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

1400 Jefferson Rd
Northfield, MN 55057
Phone (507) 663-9000

Interoperability endpoints

  • Direct secure messaging: aporter162378@excellian.direct.allina.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1447217138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 JEFFERSON RD",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573081",
            "telephone_number": "651-241-0775",
            "fax_number": "651-241-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 JEFFERSON RD",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573081",
            "telephone_number": "651-241-0775",
            "fax_number": "651-241-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "AMANDA",
        "middle_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2007030012",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aporter162378@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1400 Jefferson Rd",
            "city": "Northfield",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550573081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Northfield, MN

Sources for this page

Verify at the official NPI Registry.