NPIMap

Individual provider Active NPI

Carl Douglas Porter, MD

  • Physical Medicine & Rehabilitation Physician
  • Springfield, OH
National Provider Identifier
1720087463
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
35064697 Issued in OH
Practice address
100 Medical Center Dr
Springfield, OH 45504-2687
Phone
(937) 523-1034
Fax
(937) 523-1966
NPI assigned
Jul 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 35064697 OH Primary

Addresses

Primary practice location

100 Medical Center Dr
Springfield, OH 45504-2687

Mailing address

100 Medical Center Dr
Springfield, OH 45504-2687
Phone (937) 523-1034

Other identifiers 1

IdentifierTypeStateIssuer
0922443MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040721001290 OH Practitioner - Physical Medicine and Rehabilitation 5294715157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Ohio State University College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Springfield Specialty Care LLC 129 clinicians

Practice addresses (Care Compare)

211 Northparke Dr
Springfield, OH 45503-1117
Phone (937) 390-1700

Hospital & facility affiliations

  • Springfield Regional Medical Center Hospital, Springfield, OH, CCN 360086
  • Ohio Valley Surgical Hospital Hospital, Springfield, OH, CCN 360355
  • Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
  • Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
  • Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
  • Community of Springfield Inpatient rehabilitation facility, Springfield, OH, CCN 36T086

Merit-based Incentive Payment System (MIPS)

Final score
91.08 of 100Reported as individual
Quality
74.92
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35064697OHMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Springfield Specialty Care LLC CurrentSince Sep 1, 2020 Accepting new patients
Community Mercy Health Partners Past Accepting new patients
Medical Service Associates of Xenia Inc Physical Medicine & Rehabilitation Past Accepting new patients

Locations

100 Medical Center Dr
Springfield, OH 45504
Phone (937) 523-1000

211 Northparke Dr
Springfield, OH 45503
Phone (937) 390-1700

2600 N Limestone St
Ste 175
Springfield, OH 45503
Phone (937) 523-9980

900 Scioto St
Ste 1
Urbana, OH 43078
Phone (937) 653-4666

Interoperability endpoints

  • Direct secure messaging: cporter45742@direct.bsmhealth.org

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1720087463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042687",
            "telephone_number": "937-523-1034",
            "fax_number": "937-523-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER DR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455042687",
            "telephone_number": "937-523-1034",
            "fax_number": "937-523-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "CARL DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-15",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OH",
            "license": "35064697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0922443",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.