Sara Porter

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

30454 Issued in MS

Practice address

401 Baptist Dr Ste 301
Madison, MS 39110-2012

Phone

(601) 499-0935

Fax

(601) 499-0936

NPI assigned

Apr 13, 2018

Last updated

Sep 6, 2023By 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 2

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

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  NPD
• State of Mississippi - University of Mississippi Medical Center

  • Prosthetic/Orthotic Supplier
  • Jackson, MS
  • NPI 1235019530
  NPD
• State of Mississippi-University of Mississippi Medical Center

  dba University of Mississippi Medical Center-Grenada Specialty Clinic

  • Family Medicine Physician
  • Grenada, MS
  • NPI 1932538527
  NPD

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

{
    "created_epoch": "1523577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1568959773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BAPTIST DR STE 301",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BAPTIST DR STE 301",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391102012",
            "telephone_number": "601-499-0935",
            "fax_number": "601-499-0936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-815-1362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-13",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MS",
            "license": "T-3840",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MS",
            "license": "30454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Patrice Polk
• Sydney McCary Ponder
• Meghan Page Poole, M.D.
• Shekika Poole, CPT
• Sumrall Poole, D.M.D.
• Amy Potter, MD
• Madeline Jean Potter, BCBA
• Sylvia L Powell, PT
• Virginia Lea Powell, NP
• Premier Pediatric Healthcare Services

• Child & Adolescent Psychiatry Physician in Madison, MS
• Providers in Madison, MS by specialty
• Child & Adolescent Psychiatry Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.