Active NPI
Ariel Ramiez Porcalla, M.D., M.P.H.
- Pediatrics Physician
- Memphis, TN
National Provider Identifier
1457400061
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 17482
- Practice address
- 1129 Hale Rd
Memphis, TN 38116-6373 - Phone
- (901) 396-0390
- Fax
- (901) 396-8151
- NPI assigned
- Jan 10, 2007
- Last updated
- Jan 8, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 17482 | MS | Primary |
| Pediatric Infectious Diseases Physician | 2080P0208X | 17482 | MS |
Addresses
Primary practice location
1129 Hale Rd
Memphis, TN 38116-6373
Mailing address
1129 Hale Rd
Memphis, TN 38116-6373
Phone (901) 396-0390
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0126088 | Medicaid | MS |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17482 | MS | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Mississippi - University of Mississippi Medical Center | Past | Accepting new patients | |
| State of Mississippi-University of Mississippi Medical Center | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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-
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- Jackson, MS
- NPI 1699857433
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199750400000",
"number": "1457400061",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1129 HALE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381166373",
"telephone_number": "901-396-0390",
"fax_number": "901-396-8151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1129 HALE RD",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381166373",
"telephone_number": "901-396-0390",
"fax_number": "901-396-8151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORCALLA",
"first_name": "ARIEL",
"middle_name": "RAMIEZ",
"name_prefix": "Dr.",
"credential": "M.D., M.P.H.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2008-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MS",
"license": "17482",
"primary": true
},
{
"code": "2080P0208X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Infectious Diseases",
"state": "MS",
"license": "17482",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0126088",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.