Individual provider Active NPI

Alebra Lee Porter, NP

  • Adult Health Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1952563249
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
267483 Issued in NC
Practice address
1709 S 16TH St Ste a
Wilmington, NC 28401-6491
Phone
(910) 452-8633
Fax
(910) 452-8569
NPI assigned
Jun 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X UP002037C PA
Adult Health Nurse Practitioner 363LA2200X R879343 MS
Primary Care Nurse Practitioner 363LP2300X R879343 MS
Adult Health Nurse Practitioner 363LA2200X 267483 NC Primary

Addresses

Primary practice location

1709 S 16TH St Ste a
Wilmington, NC 28401-6491

Mailing address

PO Box 15109
Wilmington, NC 28408-5109
Phone (910) 392-2525

Other identifiers 1

IdentifierTypeStateIssuer
1952563249MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, WV, MD3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220928000603 VA Practitioner - Nurse Practitioner 2961437082 Reassigns benefits to 1 organization
I20250213002901 WV Practitioner - Nurse Practitioner 2961437082 Reassigns benefits to 1 organization
I20250605003412 MD Practitioner - Nurse Practitioner 2961437082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
UP002037CPAMDNurse Practitioner
R879343MSMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC Nurse Practitioner CurrentSince May 12, 2022 Accepting new patients
Senior Health Associates, P.a. CurrentSince Feb 9, 2020 Accepting new patients
Mississippi Nurse Practitioners Inc Adult Health Past Accepting new patients
Springs Road Consulting LLC Past Accepting new patients

Locations

1709 S 16th St
Ste A
Wilmington, NC 28401
Phone (910) 452-8633

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

1806 Summit Ave
Richmond, VA 23230
Phone (213) 433-2823

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1952563249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15109",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284085109",
            "telephone_number": "910-392-2525",
            "fax_number": "910-392-2827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 S 16TH ST STE A",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016491",
            "telephone_number": "910-452-8633",
            "fax_number": "910-452-8569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "ALEBRA",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "UP002037C",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R879343",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MS",
            "license": "R879343",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "267483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952563249",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.