Robert Charles Porter, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036054450 Issued in IL

Practice address

605 Fulton Ave
Suite 2002
Rockford, IL 61103-4179

Phone

(815) 964-6334

Fax

(815) 964-1162

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Preventive Medicine

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Porter Medical Group PCGroup PAC ID 3274066865, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Porter Medical Group P.C.

  • Occupational Medicine Physician
  • Denver, CO
  • NPI 1790395002
  Medicare reassignment Care Compare group NPD
• Network Medical Review Company LTD

  • Case Management Agency
  • Rockford, IL
  • NPI 1407079197
  NPD (past) Authorized official

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871621144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 FULTON AVE",
            "address_2": "SUITE 2002",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611034179",
            "telephone_number": "815-964-6334",
            "fax_number": "815-964-1162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 FULTON AVE",
            "address_2": "SUITE 2002",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611034179",
            "telephone_number": "815-964-6334",
            "fax_number": "815-964-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036054450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036054450",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandon Matthew Popp, DO
• Lori Poppen, LCPC
• Portable Medical Resources LTD
• Eliott Porter, PTA
• Kirstin Journey Porter, RBT
• Tajinee R Porter, PA-C
• Positive Reflections Adult Day Care LLC
• Thomas J Poswilko, OD
• Sara Marie Pottinger
• Michael Potts, MD

• Emergency Medicine Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.