Amanda Lee Porter, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH11475 Issued in FL

Practice address

2160 Dunn Ave
Jacksonville, FL 32218-4718

Phone

(904) 743-2222

Fax

(904) 743-3087

NPI assigned

Jul 28, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Axiom Pain Management LLC

  • Interventional Pain Medicine Physician
  • Jacksonville, FL
  • NPI 1184945917
  NPD (past)

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1831574110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6947 MERRILL RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322772684",
            "telephone_number": "904-743-2222",
            "fax_number": "904-743-3087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 DUNN AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184718",
            "telephone_number": "904-743-2222",
            "fax_number": "904-743-3087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "AMANDA",
        "middle_name": "LEE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lissetty Portal Mollinedo
• Eric Portalatin
• Manuel Portalatin, MD
• Sidney Porte, PT
• Abby Porter, ARNP
• Brandon Emil Porter, PHARMD
• Burgess Devone Porter II
• Candace Porter, LCSW
• Irivelisse Stevens Porter, DMD
• Ivan Porter, MD

• Chiropractor in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.