Individual provider Active NPI

Laura Porter, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Gilbert, AZ
National Provider Identifier
1639877640
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
295354 Issued in AZ
Practice address
1166 E Warner Rd Ste 113
Gilbert, AZ 85296-3065
Phone
(480) 815-7311
NPI assigned
Feb 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN159980 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 295354 AZ Primary

Addresses

Primary practice location

1166 E Warner Rd Ste 113
Gilbert, AZ 85296-3065

Mailing address

1166 E Warner Rd Ste 113
Gilbert, AZ 85296-3065
Phone (480) 815-7311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231106000506 AZ Practitioner - Nurse Practitioner 2769839265 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intentional Healing LLCGroup PAC ID 6406378165, 2 clinicians

Practice addresses (Care Compare)

1166 E Warner Rd
Suite 113
Gilbert, AZ 85296-3065
Phone (480) 815-7311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
295354AZMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Axispoint Psychiatryllc Psychiatric/Mental Health Current Accepting new patients
Intentional Healing LLC Psychiatric/Mental Health CurrentSince Feb 19, 2025 Accepting new patients
Lighthouse Psychiatry LLC Nurse Practitioner CurrentSince Jan 1, 2024 Accepting new patients
Synovation Integrated Partners, LLC Psychiatric/Mental Health CurrentSince Sep 9, 2023 Accepting new patients

Locations

1166 E Warner Rd
Ste 113
Gilbert, AZ 85296
Phone (480) 815-7311

4001 E Baseline Rd
Ste 204
Gilbert, AZ 85234
Phone (480) 269-2971

4001 E Baseline Rd
Gilbert, AZ 85234
Phone (480) 926-6200

3707 E Southern Ave
Ste 2053
Mesa, AZ 85206
Phone (414) 419-7652

Interoperability endpoints

  • Direct secure messaging: laura.porter.2@32088.direct.athenahealth.com

Organizations & group practices 4

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": "1676851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1639877640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1166 E WARNER RD STE 113",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963065",
            "telephone_number": "480-815-7311",
            "fax_number": "480-939-5055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 E WARNER RD STE 113",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852963065",
            "telephone_number": "480-815-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "LAURA",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-20",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN159980",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "295354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.