Organization Active NPI

Porter Physician Services LLC

  • Family Medicine Physician
  • Valparaiso, IN
National Provider Identifier
1508075680
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PORTER PHYSICIAN SERVICES LLC
Practice address
85 E US Highway 6
Valparaiso, IN 46383-8947
Phone
(219) 983-6380
Fax
(219) 983-6080
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Authorized official

Name
Kristina Music
Title
Director, Provider Enrollment
Phone
(877) 892-9815

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X 28143009A IN

Addresses

Primary practice location

85 E US Highway 6
Valparaiso, IN 46383-8947

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (615) 465-7402

Other identifiers 4

IdentifierTypeStateIssuer
100388930MedicaidIN
DG1244OtherINRR MCR
113435OtherINANTHEM MEDICAID
5251392OtherINAETNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070810000409 IN Part B Supplier - Clinic/Group Practice 1850482407 Receives reassigned benefits from 173 practitioners
2 other NPIs on this enrollment
Practice locations: Valparaiso, IN; Wheatfield, IN; Wanatah, IN; Chesterton, IN; Crown Point, IN; Goshen, IN; Knox, IN; La Porte, IN…

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1140 S Calumet Rd
Ste 2B
Chesterton, IN 46304
Phone (219) 926-6717

1855 S Main St
Goshen, IN 46526
Phone (219) 983-6300

7874 E RDG Rd
Hobart, IN 46342
Phone (844) 778-3627

7890 E Ridge Rd
Hobart, IN 46342
Phone (219) 788-1237

600 Legacy Plz W
Laporte, IN 46350
Phone (219) 362-8761

1919 Lake Ave
Ste 107
Plymouth, IN 46563
Phone (219) 983-6230

3630 Willowcreek Rd
#3
Portage, IN 46368
Phone (219) 392-7801

6200 Central Ave
Portage, IN 46368
Phone (219) 762-1040

3630 Willowcreek Rd
Ste 4
Portage, IN 46368
Phone (219) 263-7700

2206 Roosevelt Rd
Ste A
Valparaiso, IN 46383
Phone (219) 464-2285

2000 Roosevelt Rd
Ste 204
Valparaiso, IN 46383
Phone (219) 531-8600

401 Wall St
Unit F
Valparaiso, IN 46383
Phone (219) 462-2106

1101 Glendale Blvd
Ste 102A
Valparaiso, IN 46383
Phone (219) 263-7550

85 E US Highway 6
Ste 120
Valparaiso, IN 46383
Phone (219) 983-6120

809 Laporte Ave
#A
Valparaiso, IN 46383
Phone (219) 477-1013

1101 Glendale Blvd
Ste 111
Valparaiso, IN 46383
Phone (219) 464-1001

85 E US Highway 6
Ste 220
Valparaiso, IN 46383
Phone (219) 402-5057

2102 Evans Ave
Ste 116
Valparaiso, IN 46383
Phone (219) 464-9521

3988 W State Road 10
Wheatfield, IN 46392
Phone (219) 270-3400

521 E 13th St
Winamac, IN 46996
Phone (219) 464-1001

Practitioners & affiliated clinicians

Practitioners 210

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 210

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750896000000",
    "number": "1508075680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "615-465-7402",
            "fax_number": "615-465-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 E US HIGHWAY 6",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463838947",
            "telephone_number": "219-983-6380",
            "fax_number": "219-983-6080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTER PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "MUSIC",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "DIRECTOR, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "877-892-9815"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28143009A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100388930",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "DG1244",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM MEDICAID",
            "identifier": "113435",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5251392",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valparaiso, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.