Active NPI
Deborah Jean Porteus, PT
- Physical Therapist
- Espanola, NM
National Provider Identifier
1891836797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1359
- Practice address
- 98 County Road 119
Espanola, NM 87532-3508 - Phone
- (505) 753-2045
- Fax
- (505) 753-2045
- NPI assigned
- Feb 12, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1359 | NM | Primary |
Addresses
Primary practice location
98 County Road 119
Espanola, NM 87532-3508
Mailing address
98 County Road 119
Espanola, NM 87532-3508
Phone (505) 753-2045
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D1562 | Medicaid | NM |
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 |
|---|---|---|---|
| 1359 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1891836797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98 COUNTY ROAD 119",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875323508",
"telephone_number": "505-753-2045",
"fax_number": "505-753-2045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "98 COUNTY ROAD 119",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875323508",
"telephone_number": "505-753-2045",
"fax_number": "505-753-2045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PORTEUS",
"first_name": "DEBORAH",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-12",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "1359",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D1562",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.