NPIMap

Individual provider Active NPI

Dorothy Whatley Porter, PA

  • Medical Physician Assistant
  • Port Orange, FL
National Provider Identifier
1871849133
Registry record updated May 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9106692 Issued in FL
Practice address
3635 S Clyde Morris Blvd
Suite 100
Port Orange, FL 32129-2300
Phone
(386) 788-1242
Fax
(386) 756-8802
NPI assigned
Jul 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9106692 FL Primary

Addresses

Primary practice location

3635 S Clyde Morris Blvd
Suite 100
Port Orange, FL 32129-2300

Mailing address

4800 Belfort Rd
Jacksonville, FL 32256-6004
Phone (904) 483-5826

Other identifiers 2

IdentifierTypeStateIssuer
006441000MedicaidFL
Y0CE7OtherFLBCBS

Other names 1

  • Dorothy Jean Whatley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120830000323 FL Practitioner - Physician Assistant 9739336546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Borland Groover Clinic, PAGroup PAC ID 6507761301, 128 clinicians

Practice addresses (Care Compare)

305 Clyde Morris Blvd
Suite 270
Ormond Beach, FL 32174-8182
Phone (386) 788-1242

3635 S Clyde Morris Blvd
Suite 100
Port Orange, FL 32129-2349
Phone (386) 788-1242

836 Prudential Dr
Suite 801
Jacksonville, FL 32207-8335
Phone (904) 288-0433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.94 of 100Reported as group
Quality
69.69
Promoting interoperability
89
Improvement activities
40
Cost
69.28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: dorothy.porterpac.p1@direct.bgclinic.nextgenshare.com

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1871849133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004",
            "telephone_number": "904-483-5826",
            "fax_number": "904-265-6409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3635 S CLYDE MORRIS BLVD",
            "address_2": "SUITE 100",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321292300",
            "telephone_number": "386-788-1242",
            "fax_number": "386-756-8802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "DOROTHY",
        "middle_name": "WHATLEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006441000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y0CE7",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOROTHY",
            "last_name": "WHATLEY",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

Verify at the official NPI Registry.