Active NPI
Jessica Marie Porter, PHARMD
- Pharmacist
- Orange Beach, AL
National Provider Identifier
1669138608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 17018
- Practice address
- 25761 Perdido Beach Blvd
Orange Beach, AL 36561-6107 - Phone
- (251) 974-1590
- NPI assigned
- Nov 15, 2021
- Last updated
- Nov 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS57365 | FL | |
| Pharmacist | 183500000X | 22878 | NC | |
| Pharmacist | 183500000X | 17018 | AL | Primary |
Addresses
Primary practice location
25761 Perdido Beach Blvd
Orange Beach, AL 36561-6107
Mailing address
28760 Perdido Beach Blvd Unit 604SE
Orange Beach, AL 36561-3369
Phone (251) 987-0486
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22878 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| 17018 | AL | MD | Pharmacist |
| PS57365 | FL | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alabama CVS Pharmacy, L.L.C. | Current | Accepting new patients | |
| Alabama CVS Pharmacy LLC | Past | Accepting new patients |
Locations
25761 Perdido Beach Blvd
Orange Beach, AL 36561
Phone (251) 974-1590
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1669138608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28760 PERDIDO BEACH BLVD UNIT 604SE",
"city": "ORANGE BEACH",
"state": "AL",
"postal_code": "365613369",
"telephone_number": "251-987-0486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25761 PERDIDO BEACH BLVD",
"city": "ORANGE BEACH",
"state": "AL",
"postal_code": "365616107",
"telephone_number": "251-974-1590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "JESSICA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-15",
"last_updated": "2021-11-15",
"certification_date": "2021-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS57365",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NC",
"license": "22878",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "17018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange Beach, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.