Individual provider Active NPI

Stephanie S Porter, L.P.T.

  • Physical Therapist
  • Boardman, OH
National Provider Identifier
1659327880
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008791 Issued in OH
Practice address
1265 Boardman Canfield Rd
Boardman, OH 44512-4004
Phone
(330) 758-9400
Fax
(330) 726-8676
NPI assigned
May 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT008791 OH Primary

Addresses

Primary practice location

1265 Boardman Canfield Rd
Boardman, OH 44512-4004

Mailing address

1265 Boardman Canfield Rd
Boardman, OH 44512-4004
Phone (330) 758-9400

Other identifiers 1

IdentifierTypeStateIssuer
2450904MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031217000150 OH Practitioner - Physical Therapist in Private Practice 3971400052 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Sports and Spine Institute LTDGroup PAC ID 6800792938, 12 clinicians
Northern Ohio Medical Specialists,LLCGroup PAC ID 2769386192, 252 clinicians

Practice addresses (Care Compare)

1265 Boardman Canfield Rd
Boardman, OH 44512-4010
Phone (330) 758-9400

2500 W Strub Rd
Sandusky, OH 44870-5390
Phone (419) 626-6161

Merit-based Incentive Payment System (MIPS)

Final score
80.23 of 100Reported as group
Quality
59.13
Promoting interoperability
99
Improvement activities
40
Cost
75.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT008791OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Ohio Medical Specialists, LLC CurrentSince Feb 18, 2019 Accepting new patients
Northern Ohio Medical Specialists LLC CurrentSince Feb 18, 2019 Accepting new patients

Locations

16844 Saint Clair Ave
East Liverpool, OH 43920
Phone (330) 385-2413

16844 Saint Clair Ave
Ste 2
East Liverpool, OH 43920
Phone (330) 385-2413

2380 Southeast Blvd
Salem, OH 44460
Phone (330) 332-0426

3004 Hayes Ave
Sandusky, OH 44870
Phone (419) 625-2841

2500 W Strub Rd
Sandusky, OH 44870
Phone 41960911123061

1265 Boardman Canfield Rd
Youngstown, OH 44512
Phone (330) 758-8808

8175 Market St
Youngstown, OH 44512
Phone (330) 629-8800

Organizations & group practices 3

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1659327880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124004",
            "telephone_number": "330-758-9400",
            "fax_number": "330-726-8676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124004",
            "telephone_number": "330-758-9400",
            "fax_number": "330-726-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "STEPHANIE",
        "middle_name": "S",
        "credential": "L.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT008791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2450904",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.