Active NPI
Edwin D Porter, DM, DC
- Chiropractor
- Canton, OH
National Provider Identifier
1689602039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 316
- Practice address
- 4531 Everhard Rd NW
Canton, OH 44718-2406 - Phone
- (330) 499-0642
- Fax
- (330) 499-2257
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 316 | OH | Primary |
Addresses
Primary practice location
4531 Everhard Rd NW
Canton, OH 44718-2406
Mailing address
1247 Maxfli Dr
Akron, OH 44312-5930
Phone (330) 936-4111
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 341258286027 | Other | OH | CARESOURCE |
| 009880-8 | Medicaid | OH | |
| 000000164597 | Other | OH | ANTHEM BC/BS |
| P00247842 | Other | OH | RAILROAD MEDICARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 316 | OH | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Porter Chiropractic Clinic | Chiropractor | Past | Accepting new patients |
| Sprandel Chiropractic Clinic Inc | Chiropractor | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Chiropractor
- Canton, OH
- NPI 1063668374
-
- Chiropractor
- Canton, OH
- NPI 1629247960
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689602039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1247 MAXFLI DR",
"city": "AKRON",
"state": "OH",
"postal_code": "443125930",
"telephone_number": "330-936-4111",
"fax_number": "330-499-2257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4531 EVERHARD RD NW",
"city": "CANTON",
"state": "OH",
"postal_code": "447182406",
"telephone_number": "330-499-0642",
"fax_number": "330-499-2257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "EDWIN",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DM, DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "316",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE",
"identifier": "341258286027",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009880-8",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "000000164597",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00247842",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.