Polly Ann Porter, PA-C, ATC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

0110001565 Issued in VA

Practice address

35731 Dunthorpe LN
Purcellville, VA 20132-5225

Phone

(703) 395-3885

NPI assigned

Sep 11, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MVP Assisting, LLC

  • Physician Assistant
  • Purcellville, VA
  • NPI 1538431523
  Authorized official Same address or phone
• Porter Performance

  • Contractor
  • Purcellville, VA
  • NPI 1518204908
  NPD (past) Authorized official

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1568566503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35731 DUNTHORPE LN",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201325225",
            "telephone_number": "703-395-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35731 DUNTHORPE LN",
            "city": "PURCELLVILLE",
            "state": "VA",
            "postal_code": "201325225",
            "telephone_number": "703-395-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "POLLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PA-C, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "VA",
            "license": "0110001565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Perri L Bonar DPM PLLC
• Peter M Daddio DC
• Weenonah R Phelps, PTA
• Brittany Pitta
• Porter Performance
• Positive Reinforcement PLLC
• Nancy Dutton Potter, PHD
• Progressive Physical Therapy and Rehabilitation
• PT Joint
• Purcellville Family Healthcare, P.C.

• Surgical Physician Assistant in Purcellville, VA
• Providers in Purcellville, VA by specialty
• Surgical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.