Individual provider Active NPI

Caroline Leigh Porter

  • Dermatology Physician
  • Travelers Rest, SC
National Provider Identifier
1932769429
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
86587 Issued in SC
Practice address
36 S Main St Ste a
Travelers Rest, SC 29690-1872
Phone
(864) 305-4108
NPI assigned
Jun 17, 2019
Last updated
Sep 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 86587 SC Primary

Addresses

Primary practice location

36 S Main St Ste a
Travelers Rest, SC 29690-1872

Mailing address

7300 Ranch Road 2222 Ste 200
Austin, TX 78730-3204
Phone (512) 628-0465

Other practice location 1

110 Irving St NW
Washington, DC 20010-3017
Phone (301) 951-2400

Other practice location 2

One Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 409-4787

Other identifiers 1

IdentifierTypeStateIssuer
MTL500001960MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20190909001057 NC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0749519296

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86587SCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Epiphany Dermatology of South Carolina LLC Dermatology CurrentSince Jul 1, 2026 Accepting new patients

Locations

28 Medical Ridge Dr
Greenville, SC 29605
Phone (864) 271-7440

317 Tanner Rd
Greenville, SC 29607
Phone (864) 627-8911

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1932769429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 RANCH ROAD 2222 STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787303204",
            "telephone_number": "512-628-0465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 S MAIN ST STE A",
            "city": "TRAVELERS REST",
            "state": "SC",
            "postal_code": "296901872",
            "telephone_number": "864-305-4108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Irving St NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200103017",
            "country_code": "US",
            "telephone_number": "301-951-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "One Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271570001",
            "country_code": "US",
            "telephone_number": "336-409-4787",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "CAROLINE",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "SC",
            "license": "86587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MTL500001960",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Travelers Rest, SC

Sources for this page

Verify at the official NPI Registry.