Individual provider Active NPI

William Harris Porter, PHD

  • Clinical Psychologist
  • Mt Pleasant, IA
National Provider Identifier
1508991613
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
00594 Issued in IA
Practice address
307 W Monroe St
Mt Pleasant, IA 52641-2112
Phone
(319) 385-4277
Fax
(319) 395-4277
NPI assigned
Feb 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 00594 IA Primary

Addresses

Primary practice location

307 W Monroe St
Mt Pleasant, IA 52641-2112

Mailing address

307 W Monroe St
Mt Pleasant, IA 52641-2112
Phone (319) 385-4277

Other identifiers 4

IdentifierTypeStateIssuer
0264903OtherIAUBH ID
15821OtherIABCBS OF NORTH DAKOTA
0264903MedicaidIA
42152563801OtherIAJOHN DEERE HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161209001905 IA Practitioner - Clinical Psychologist 8729368675

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Earth Please Foundation PastSince Oct 20, 2016 Accepting new patients
Optimae Lifeservices, Inc, Past Accepting new patients
Nurse in the House, Inc. Past Accepting new patients

Organizations & group practices 3

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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1508991613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 W MONROE ST",
            "city": "MT PLEASANT",
            "state": "IA",
            "postal_code": "526412112",
            "telephone_number": "319-385-4277",
            "fax_number": "319-395-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W MONROE ST",
            "city": "MT PLEASANT",
            "state": "IA",
            "postal_code": "526412112",
            "telephone_number": "319-385-4277",
            "fax_number": "319-395-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "WILLIAM",
        "middle_name": "HARRIS",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "00594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH  ID",
            "identifier": "0264903",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NORTH DAKOTA",
            "identifier": "15821",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0264903",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH",
            "identifier": "42152563801",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, IA

Sources for this page

Verify at the official NPI Registry.