Active NPI
Julia Amanda Porter, MA, ATC, LAT, CSCS
- Specialist
- Concord, NC
National Provider Identifier
1841641420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1036
- Practice address
- 481 Burrage Rd NE
Concord, NC 28025-2623 - Phone
- (704) 786-4161
- Fax
- (704) 782-7539
- NPI assigned
- Jun 25, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 1036 | NC | Primary |
Addresses
Primary practice location
481 Burrage Rd NE
Concord, NC 28025-2623
Mailing address
481 Burrage Rd NE
Concord, NC 28025-2623
Phone (704) 786-4161
Other names 1
- Julia Amanda Grossman
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1036 | NC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466812800000",
"number": "1841641420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "481 BURRAGE RD NE",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252623",
"telephone_number": "704-786-4161",
"fax_number": "704-782-7539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "481 BURRAGE RD NE",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252623",
"telephone_number": "704-786-4161",
"fax_number": "704-782-7539"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTER",
"first_name": "JULIA",
"middle_name": "AMANDA",
"credential": "MA, ATC, LAT, CSCS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-25",
"last_updated": "2016-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NC",
"license": "1036",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JULIA",
"last_name": "GROSSMAN",
"middle_name": "AMANDA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.