Tammie Jean Porras, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R155408-9 Issued in MN

Practice address

4600 Lake Road Ave Ste 301
Robbinsdale, MN 55422-1845

Phone

(763) 588-7099

Fax

(763) 522-2222

NPI assigned

Jul 5, 2006

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

Other identifiers 2

Other names 1

• Tammie Jean Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Medical Consultants Clinic PA

  • Clinic/Center
  • Robbinsdale, MN
  • NPI 1447711015
  NPD (past)
• Realief Medical, P.a.

  • Pain Medicine Physician
  • St Louis Park, MN
  • NPI 1659464162
  NPD (past)

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1649201161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 LAKE ROAD AVE STE 301",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554221845",
            "telephone_number": "763-588-7099",
            "fax_number": "763-522-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 LAKE ROAD AVE STE 301",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554221845",
            "telephone_number": "763-588-7099",
            "fax_number": "763-522-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRAS",
        "first_name": "TAMMIE",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R155408-9",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "R155408-9",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1508102500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "CO9271",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMMIE",
            "last_name": "JOHNSON",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Philip F Fabel DDS PA
• Claire Kathleen Philippe, DO
• Mark Alan Pilot, MD
• Alexandra Elizabeth Plonsky, RN
• Adam Poquette
• Madison Powell
• Abigail Marie Praska, DNP, CRNA
• Prestigious Care Homes LLC
• William F Pucel, D.D.S.
• William Puhl

• Adult Health Nurse Practitioner in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Adult Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.