Individual provider Active NPI

Kimberly Kay Porter, M.D.

  • Hospitalist Physician
  • Oklahoma City, OK
National Provider Identifier
1508962358
Registry record updated May 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
20583 Issued in OK
Practice address
921 NE 13TH St
Oklahoma City, OK 73104-5007
Phone
(405) 270-0501
Fax
(405) 270-5956
NPI assigned
Sep 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 20583 OK
Hospitalist Physician 208M00000X 20583 OK Primary

Addresses

Primary practice location

921 NE 13TH St
Oklahoma City, OK 73104-5007

Mailing address

2517 NW 13TH St
Oklahoma City, OK 73107-4809
Phone (405) 525-0483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090203000666 OK Practitioner - Geriatric MedicinePractitioner - Internal Medicine 2264596378 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Southern Illinois University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient Care Physician Services LLCGroup PAC ID 5092839357, 11 clinicians
Premier Paradox Inc.Group PAC ID 4183067481, 3 clinicians

Practice addresses (Care Compare)

1409 Territories Dr
Edmond, OK 73034-2650
Phone (405) 657-3120

3524 NW 56TH St
Oklahoma City, OK 73112-4518
Phone (405) 657-3120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20583OKMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Paradox Inc Hospitalist CurrentSince Jan 23, 2024 Accepting new patients

Locations

3524 NW 56th St
Oklahoma City, OK 73112
Phone (405) 606-6700

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746316800000",
    "number": "1508962358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2517 NW 13TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731074809",
            "telephone_number": "405-525-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 NE 13TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045007",
            "telephone_number": "405-270-0501",
            "fax_number": "405-270-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "KIMBERLY",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-16",
        "last_updated": "2025-05-04",
        "certification_date": "2025-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "20583",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OK",
            "license": "20583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.