Port45 Recovery LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

PORT45 RECOVERY LLC

Practice address

1616 Grant St
Portsmouth, OH 45662-3663

Phone

(740) 529-7356

NPI assigned

Jun 8, 2016

Organization subpart

No

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

Authorized official

Name

Sharon StaleyNPI 1194205658

Title

Ceo

Phone

(419) 606-3141

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sharon Staley, CDCA

  • Addiction (Substance Use Disorder) Counselor
  • Columbus, OH
  • NPI 1194205658
  NPD Authorized official
• Morgan Basham

  • Addiction (Substance Use Disorder) Counselor
  • Portsmouth, OH
  • NPI 1568908291
  NPD (past)
• Jo Anna Donini

  • Addiction (Substance Use Disorder) Counselor
  • Wheelersburg, OH
  • NPI 1811434434
  NPD (past)
• Erica Rochelle Shumway, APRN, FNP-C

  • Family Nurse Practitioner
  • Ashland, KY
  • NPI 1699288357
  NPD (past)

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1780033993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 EASTWIND DR STE 101",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430815302",
            "telephone_number": "614-591-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 GRANT ST",
            "city": "PORTSMOUTH",
            "state": "OH",
            "postal_code": "456623663",
            "telephone_number": "740-529-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT45 RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-08",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "STALEY",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "419-606-3141"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YA0400X",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa G Poorman
• Luke T Porginski, ACNPC-AG
• Porsmouth Hospital Corporation
• Porsmouth Hospital Corporation
• Port45 Recovery LLC
• Kacee Porter, CDCA
• Portsmouth Al Opco LLC
• Portsmouth Ambulette Services
• Portsmouth City School District
• Portsmouth City School District

• Addiction (Substance Use Disorder) Counselor in Portsmouth, OH
• Providers in Portsmouth, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.