Amy Jo Porter, PTA

Primary specialty

SpecialistTaxonomy code 174400000X

License

A1039 Issued in MN

Practice address

435 Phalen Blvd
Saint Paul, MN 55130-5302

Phone

(651) 254-3200

NPI assigned

Feb 27, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Amy Jo Haugen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1922548809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6614 LACASSE DR",
            "city": "LINO LAKES",
            "state": "MN",
            "postal_code": "550387703",
            "telephone_number": "651-235-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 PHALEN BLVD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551305302",
            "telephone_number": "651-254-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "AMY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "A1039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "HAUGEN",
            "middle_name": "JO",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristina Popov, FNP
• Nadia Poquette, PA
• Joan Porcher, RD
• Carolyn Marie Porta, PHD, MPH, RN, SANE-A
• Eleanor Porter-Nelson, MSW
• Shasha Caroline Porter
• Lisa D Portinga, MSW
• Andrew John Portis, M.D.
• Angela Posine, CD(DONA)
• Brian Christopher Post, PH.D.

• Specialist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; 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.