Stuart B Porter, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

288579-1204 Issued in UT

Practice address

3650 N University Ave
Suite 200
Provo, UT 84604-6656

Phone

(801) 375-7100

Fax

(801) 375-7102

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2015 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251763200000",
    "number": "1689612996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 N UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046656",
            "telephone_number": "801-375-7100",
            "fax_number": "801-375-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 N UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046656",
            "telephone_number": "801-375-7100",
            "fax_number": "801-375-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "STUART",
        "middle_name": "B",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2009-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "288579-1204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D0860",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregory Porter, LCSW
• Logan Porter
• Rachel Porter
• Rick Benson Porter, DPT
• Ryan Joseph Porter, DDS
• Lorien Potter
• Aaron Potts
• Richard W Potts, PHD
• Jeffrey David Poulsen, MD
• Bryan Rex Poulson

• Family Medicine Physician in Provo, UT
• Providers in Provo, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.