Jennae Marie Porter, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

AMD-1050 Issued in HI

Practice address

59-016 Holawa St
Haleiwa, HI 96712

Phone

(808) 754-9037

NPI assigned

Nov 14, 2007

Last updated

Aug 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bill H. Halmi MD, PC

  dba Arizona Advanced Dermatology

  • Specialist
  • Phoenix, AZ
  • NPI 1487645123
  NPD (past)

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1811177231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59-016 HOLAWA ST",
            "city": "HALEIWA",
            "state": "HI",
            "postal_code": "96712",
            "telephone_number": "808-754-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59-016 HOLAWA ST",
            "city": "HALEIWA",
            "state": "HI",
            "postal_code": "96712",
            "telephone_number": "808-754-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JENNAE",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-14",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3739",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "HI",
            "license": "AMD-1050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances Abigail Parker
• Mykaela Percy, LPN
• Rebecca Taylor Pierce, MSW, LSW, CSW
• Kehau Plemer, M.S. CCC-SLP
• Elizabeth Porter
• McCall Prentice
• Queen's Development Corporation & Subsidiaries
• Recharge Therapy LLC
• Lauren Alicia Reinert, MS, ATC, CSCS
• Jacquelyn Victoria Vaughan Reiser, D.P.T.

• Medical Physician Assistant in Haleiwa, HI
• Providers in Haleiwa, HI by specialty
• Medical Physician Assistant in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.