Individual provider Active NPI

John Leslie Porter, RPH

  • Pharmacist
  • Louisville, KY
National Provider Identifier
1609156215
Registry record updated Aug 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
007624 Issued in KY
Practice address
990 Baxter Ave
Louisville, KY 40204-2064
Phone
(502) 585-3239
Fax
(502) 583-3162
NPI assigned
Aug 26, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 007624 KY Primary

Addresses

Primary practice location

990 Baxter Ave
Louisville, KY 40204-2064

Mailing address

10101 Sycamore Shoals CT
Louisville, KY 40223-3354
Phone (502) 244-1752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
007624KYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

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": "1314316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314316800000",
    "number": "1609156215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 SYCAMORE SHOALS CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402233354",
            "telephone_number": "502-244-1752",
            "fax_number": "502-244-1752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 BAXTER AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402042064",
            "telephone_number": "502-585-3239",
            "fax_number": "502-583-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JOHN",
        "middle_name": "LESLIE",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "007624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; 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.