Individual provider Active NPI

Amanda Lynn Porter, MD

  • Neurology Physician
  • Kalkaska, MI
National Provider Identifier
1639638729
Registry record updated Apr 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
90096 Issued in SC
Practice address
419 S Coral St
Kalkaska, MI 49646-2503
Phone
(231) 258-7777
NPI assigned
Mar 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X TRN29276 FL
Neurology Physician 2084N0400X 90096 SC Primary
Behavioral Neurology & Neuropsychiatry Physician 2084B0040X 4301512346 MI
Neurology Physician 2084N0400X TRN29276 FL
Neurology Physician 2084N0400X 4301512346 MI
Neurology Physician 2084N0400X ME147513 FL

Addresses

Primary practice location

419 S Coral St
Kalkaska, MI 49646-2503

Mailing address

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7777

Other practice location 1

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206
Phone (239) 208-2212

Other practice location 2

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 402-5035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MI, SC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230624000005 FL Practitioner - Neuropsychiatry 6709111347 Reassigns benefits to 1 organization
I20240718003387 MI Practitioner - NeurologyPractitioner - Psychiatry 6709111347 Reassigns benefits to 5 organizations
I20251205000509 SC Practitioner - Neurology 6709111347 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Roper Saint Francis Physicians NetworkGroup PAC ID 5193874824, 530 clinicians
Novello Specialty Clinic PCGroup PAC ID 3870961493, 4 clinicians
Kalkaska Memorial Health CenterGroup PAC ID 3577536002, 57 clinicians

Practice addresses (Care Compare)

2095 Henry Tecklenburg Dr
Charleston, SC 29414-5733
Phone (843) 723-6426

4100 Park Forest Dr
Suite 200
Traverse City, MI 49684-7306
Phone (231) 600-7466

419 S Coral St
Kalkaska, MI 49646-2503
Phone (231) 258-7500

Hospital & facility affiliations

  • Advisacare Solutions of Northern Michigan, LLC Home health agency, Charlevoix, MI, CCN 237042
  • Kalkaska Memorial Health Center Hospital, Kalkaska, MI, CCN 231301
  • Munson Medical Center Hospital, Traverse City, MI, CCN 230097
  • McLaren Northern Michigan Hospital, Petoskey, MI, CCN 230105
  • Roper Hospital Hospital, Charleston, SC, CCN 420087
  • Charlevoix Area Hospital Hospital, Charlevoix, MI, CCN 231322

Merit-based Incentive Payment System (MIPS)

Final score
84.24 of 100Reported as group
Quality
74.85
Promoting interoperability
100
Improvement activities
40
Cost
72.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TRN29276FLMDInternal Medicine Physician
90096SCMDBrain Injury Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Jacksonville CurrentSince Jul 1, 2023 Accepting new patients
Lakeland Medical Practices Internal Medicine CurrentSince Dec 3, 2024 Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
Mayo Clinic Jacksonville Current Accepting new patients
Roper Saint Francis Physicians Network Neurology CurrentSince Nov 24, 2025 Accepting new patients
Lakeland Medical Practices Internal Medicine CurrentSince Dec 3, 2024 Accepting new patients
Mayo Clinic Jacksonville CurrentSince Jul 1, 2023 Accepting new patients
Kalkaska Memorial Health Center Internal Medicine CurrentSince Sep 25, 2025 Accepting new patients
Kalkaska Memorial Health Center CurrentSince Sep 25, 2025 Accepting new patients
Roper St. Francis Specialty Physicians Neurology CurrentSince Feb 1, 2026 Accepting new patients
McLaren Northern Michigan CurrentSince Dec 22, 2025 Accepting new patients
McLaren Central Michigan CurrentSince Dec 4, 2025 Accepting new patients
McLaren Northern Michigan CurrentSince Dec 22, 2025 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Nov 24, 2025 Accepting new patients
McLaren Central Michigan CurrentSince Dec 4, 2025 Accepting new patients

Locations

11215 Metro Pkwy
Ste 1
Fort Myers, FL 33966
Phone (239) 208-2206

4500 San Pablo Rd S
Jacksonville, FL 32224
Phone (904) 721-4815

419 S Coral St
Kalkaska, MI 49646
Phone (231) 258-7500

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

2390 Mitchell Park Dr
Ste D
Petoskey, MI 49770
Phone (231) 242-1760

560 W Mitchell St
Ste 340
Petoskey, MI 49770
Phone (231) 348-9710

416 Connable Ave
Petoskey, MI 49770
Phone (231) 487-4000

3950 Hollywood Rd
Ste 280
Saint Joseph, MI 49085
Phone (269) 408-0990

1234 Napier Ave
Saint Joseph, MI 49085
Phone (269) 982-4941

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

2097 Henry Tecklenburg Dr
Ste 211W
Charleston, SC 29414
Phone (843) 958-2555

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1639638729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 S CORAL ST",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496462503",
            "telephone_number": "231-258-7777",
            "fax_number": "231-258-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S CORAL ST",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496462503",
            "telephone_number": "231-258-7777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11215 Metro Pkwy Ste 1",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339661206",
            "country_code": "US",
            "telephone_number": "239-208-2212",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2095 Henry Tecklenburg Dr",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294145733",
            "country_code": "US",
            "telephone_number": "843-402-5035",
            "fax_number": "843-402-5036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "AMANDA",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "TRN29276",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "SC",
            "license": "90096",
            "primary": true
        },
        {
            "code": "2084B0040X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry",
            "state": "MI",
            "license": "4301512346",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "TRN29276",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301512346",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME147513",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalkaska, MI

Sources for this page

Verify at the official NPI Registry.