Individual provider Active NPI

Amber L Porter, RN

  • Registered Nurse
  • Fort Leonard Wood, MO
National Provider Identifier
1740596998
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2014018613 Issued in MO
Practice address
4430 Missouri Ave BLDG 310
Fort Leonard Wood, MO 65473
Phone
(573) 596-1770
Fax
(573) 596-1797
NPI assigned
Aug 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2014018613 MO Primary

Addresses

Primary practice location

4430 Missouri Ave BLDG 310
Fort Leonard Wood, MO 65473

Mailing address

4430 Missouri Ave BLDG 310
Fort Leonard Wood, MO 65473-9098
Phone (573) 596-1770

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2014018613MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1282780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1740596998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE BLDG 310",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654739098",
            "telephone_number": "573-596-1770",
            "fax_number": "573-596-1797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4430 MISSOURI AVE BLDG 310",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "65473",
            "telephone_number": "573-596-1770",
            "fax_number": "573-596-1797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "AMBER",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-26",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2014018613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Leonard Wood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.