Teresa Irene Porter, OTA-01110

Primary specialty

ContractorTaxonomy code 171W00000X

License

OTA 01110 Issued in OH

Practice address

66 Norwood Ave
Norwalk, OH 44857-2337

Phone

(440) 396-6085

NPI assigned

Jul 3, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1447514567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7585 PYLE SOUTH AMHERST RD",
            "city": "AMHERST",
            "state": "OH",
            "postal_code": "440012123",
            "telephone_number": "440-396-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 NORWOOD AVE",
            "city": "NORWALK",
            "state": "OH",
            "postal_code": "448572337",
            "telephone_number": "440-396-6085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "TERESA",
        "middle_name": "IRENE",
        "credential": "OTA-01110",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "OH",
            "license": "OTA 01110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THERAPY",
            "identifier": "OTA 01110",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael T Powers, D.O.
• Monica Powers, LPT
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• Mary F Previts
• Michelle Pruchnicki, LPN

• Contractor in Norwalk, OH
• Providers in Norwalk, OH by specialty
• Contractor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.