Jerry D Porter, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

GA19749 Issued in GA

Practice address

5665 Peachtree Dunwoody Rd NE
Atlanta, GA 30342-1701

Phone

(404) 252-1968

Fax

(404) 252-4609

NPI assigned

Dec 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479427200000",
    "number": "1578625448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 PEACHTREE DUNWOODY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421701",
            "telephone_number": "404-252-1968",
            "fax_number": "404-252-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 PEACHTREE DUNWOODY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421701",
            "telephone_number": "404-252-1968",
            "fax_number": "404-252-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JERRY",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2016-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "GA19749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1578625448",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Murrow Porter, PA
• Emon Porter
• Erin James Porter, NP
• Ivy Michelle Porter, M.S., CCC-SLP
• Jeffrey Lynn Porter, MA,ATC,LAT
• Johnnie B. Porter, M. DIV., M.A.C.M.
• Kacey Porter
• Keilana Porter
• Lily Porter
• Lindsey Marie Porter, M.S., CCC-SLP

• Anatomic Pathology & Clinical Pathology Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Anatomic Pathology & Clinical Pathology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.