Active NPI
Wellington Junior Porter Sr.
- Massage Therapist
- Riverside, CA
National Provider Identifier
1831947209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 37610
- Practice address
- 6681 Magnolia Ave Ste D
Riverside, CA 92506-2900 - Phone
- (951) 318-1904
- NPI assigned
- May 9, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 37610 | CA | Primary |
Addresses
Primary practice location
6681 Magnolia Ave Ste D
Riverside, CA 92506-2900
Mailing address
1315 E Marshall Blvd SPC 49
San Bernardino, CA 92404-7060
Phone (951) 318-1904
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37610 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715212800000",
"number": "1831947209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 E MARSHALL BLVD SPC 49",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924047060",
"telephone_number": "951-318-1904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6681 MAGNOLIA AVE STE D",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925062900",
"telephone_number": "951-318-1904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "WELLINGTON",
"middle_name": "JUNIOR",
"name_prefix": "Mr.",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-05-09",
"last_updated": "2024-05-09",
"certification_date": "2024-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "37610",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.