Individual provider Active NPI

Jeffrey Porter

  • Certified Registered Nurse Anesthetist
  • Saint Joseph, MO
National Provider Identifier
1477901023
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2016019080 Issued in MO
Practice address
5325 Faraon St
Saint Joseph, MO 64506-3488
Phone
(816) 271-6350
Fax
(816) 271-6753
NPI assigned
May 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2010000185 MO
Certified Registered Nurse Anesthetist 367500000X 2016019080 MO Primary

Addresses

Primary practice location

5325 Faraon St
Saint Joseph, MO 64506-3488

Mailing address

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-6350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160817000234 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810282738 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

5830 NW Barry Rd
Kansas City, MO 64154-2778
Phone (816) 891-3000

Hospital & facility affiliations

  • Saint Lukes North Hospital Hospital, Kansas City, MO, CCN 260062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2010000185MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Meritas Health Corporation Current Accepting new patients
Anesthesia Associates of Kansas City PA CurrentSince Sep 9, 2022 Accepting new patients
Meritas Health Corporation CurrentSince Sep 7, 2021 Accepting new patients
Meritas Health Corporation CurrentSince Sep 7, 2021 Accepting new patients
Saint Luke'S Physician Group Inc Nurse Anesthetist, Certified Registered CurrentSince Apr 14, 2024 Accepting new patients
Meritas Health Corporation Past Accepting new patients

Locations

19600 E 39th St S
Independence, MO 64057
Phone (816) 698-7000

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

5830 NW Barry Rd
Kansas City, MO 64154
Phone (816) 880-6441

1000 Carondelet Dr
Kansas City, MO 64114
Phone (816) 942-4400

5844 NW Barry Rd
Ste 110
Kansas City, MO 64154
Phone (816) 880-6100

2700 Clay Edwards Dr
Ste 240
North Kansas City, MO 64116
Phone (816) 455-0681

2800 Hospital Dr
North Kansas City, MO 64116
Phone (816) 221-5050

5325 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-3500

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Interoperability endpoints

  • Direct secure messaging: jporter648781@direct.saint-lukes.org

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1477901023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6350",
            "fax_number": "816-271-6753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6350",
            "fax_number": "816-271-6753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JEFFREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2010000185",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2016019080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.