Individual provider Active NPI

Chad Michael Porter, DC

  • Chiropractor
  • Bridgeport, WV
National Provider Identifier
1477082048
Registry record updated Jun 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1013 Issued in WV
Practice address
529 E Main St
Bridgeport, WV 26330-1824
Phone
(304) 842-4202
NPI assigned
Jun 7, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1013 WV Primary

Addresses

Primary practice location

529 E Main St
Bridgeport, WV 26330-1824

Mailing address

30 Westwood Cir
Washington, WV 26181-3558
Phone (304) 482-8934

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170814002457 WV Practitioner - Chiropractic 7517239320 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

138 Jim St
Morgantown, WV 26501-5302
Phone (304) 244-5575

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mike Mason Chiropractic PLLC Chiropractor CurrentSince Aug 1, 2017 Accepting new patients
Coliseum Chiropractic PLLC Chiropractor CurrentSince Jun 29, 2021 Accepting new patients

Locations

529 E Main St
Bridgeport, WV 26330
Phone (304) 376-9792

138 Jim St
Morgantown, WV 26501
Phone (304) 244-5575

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496793600000",
    "number": "1477082048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WESTWOOD CIR",
            "city": "WASHINGTON",
            "state": "WV",
            "postal_code": "261813558",
            "telephone_number": "304-482-8934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 E MAIN ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301824",
            "telephone_number": "304-842-4202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "CHAD",
        "middle_name": "MICHAEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2017-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "1013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.