Derrick Allen Porter

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

60593 Issued in AR

Practice address

20188 W Vanzant Rd
Springdale, AR 72764-8978

Phone

(479) 263-1804

NPI assigned

Jul 27, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1760406938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20188 W VANZANT RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727648978",
            "telephone_number": "479-263-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20188 W VANZANT RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727648978",
            "telephone_number": "479-263-1804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "DERRICK",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "AR",
            "license": "60593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MCO13589",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Polanco Herrera
• Tayler Elizabeth Pollock, LMSW
• Brenda Kay Pond, RNC
• Jennifer Marie Porta, D.O
• Rex L Porte, MD
• Martin D. Porter, M.D.
• Miriam Elaine Porter, AGACNP
• Trent Allen Porter
• Michelle Deann Posey, MHPP
• Matthew J Possehl

• Personal Care Attendant in Springdale, AR
• Providers in Springdale, AR by specialty
• Personal Care Attendant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.