Individual provider Active NPI

Stephanie Mae Porter

  • Emergency Registered Nurse
  • Claremore, OK
National Provider Identifier
1699247213
Registry record updated Dec 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
102328 Issued in OK
Practice address
101 S Moore Ave
Claremore, OK 74017-5047
Phone
(918) 342-6495
NPI assigned
Dec 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 102328 OK
Critical Care Medicine Registered Nurse 163WC0200X 102328 OK
Emergency Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WE0003X 102328 OK Primary

Addresses

Primary practice location

101 S Moore Ave
Claremore, OK 74017-5047

Mailing address

101 S Moore Ave
Claremore, OK 74017-5047

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

State licenses

LicenseStateTypeSpecialty
102328OKMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545264000000",
    "number": "1699247213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S MOORE AVE",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740175047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S MOORE AVE",
            "city": "CLAREMORE",
            "state": "OK",
            "postal_code": "740175047",
            "telephone_number": "918-342-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "STEPHANIE",
        "middle_name": "MAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-20",
        "last_updated": "2018-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "OK",
            "license": "102328",
            "primary": false
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OK",
            "license": "102328",
            "primary": false
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Emergency",
            "state": "OK",
            "license": "102328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Claremore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.