Theodore B Porter, DO, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS003735L Issued in PA

Legal business name

THEODORE B PORTER, DO, PC

Practice address

1413 W Moyamensing Ave
1St Floor
Philadelphia, PA 19145-4625

Phone

(267) 639-2555

Fax

(267) 639-2632

NPI assigned

Apr 26, 2013

Organization subpart

No

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

Authorized official

Name

Laruie Contino

Title

Office Administrator

Phone

(267) 639-2555

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366934400000",
    "number": "1851735302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 W MOYAMENSING AVE",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454625",
            "telephone_number": "267-639-2555",
            "fax_number": "267-639-2632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 W MOYAMENSING AVE",
            "address_2": "1ST FLOOR",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454625",
            "telephone_number": "267-639-2555",
            "fax_number": "267-639-2632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE B PORTER, DO, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-26",
        "last_updated": "2013-04-26",
        "status": "A",
        "authorized_official_last_name": "CONTINO",
        "authorized_official_first_name": "LARUIE",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "267-639-2555"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS003735L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simon Daniel Xavier Thebault, M.D.
• Elizabeth Anne Theis, PA-C
• Sandhra Thekkumthala, CRNP
• Mikiko Thelwell
• Ryna Then, M.D.
• Nicole Michelle Theodore, REGISTERED NURSE
• Ioannis Theodoropoulos, M.D.
• Nicholas Theodoropoulos, MD
• Georges Theodule, PMHNP-BC
• Thana Theofanis, M.D.

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2013; 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.