Individual provider Active NPI

Sheridan Lynelle Porter, FNP

  • Family Nurse Practitioner
  • Show Low, AZ
National Provider Identifier
1962224790
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
316188 Issued in AZ
Practice address
4951 S White Mountain Rd
Show Low, AZ 85901-7827
Phone
(928) 228-8384
NPI assigned
Oct 31, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 316188 AZ Primary

Addresses

Primary practice location

4951 S White Mountain Rd
Show Low, AZ 85901-7827

Mailing address

584 E Greer Ave
Snowflake, AZ 85937-5172
Phone (928) 228-8384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241212003273 AZ Practitioner - Nurse Practitioner 6709312804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

4951 S White Mountain Rd
BLDG a
Show Low, AZ 85901-7801
Phone (928) 537-6700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
316188AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Healthcare Medical Associates CurrentSince Feb 1, 2025 Accepting new patients
Summit Healthcare Association Nurse Practitioner Current Accepting new patients
Summit Healthcare Medical Associates Nurse Practitioner Current Accepting new patients
Summit Healthcare Medical Associates CurrentSince Feb 1, 2025 Accepting new patients
Summit Healthcare Association Past Accepting new patients

Locations

2200 E Show Low Lake Rd
Show Low, AZ 85901
Phone (928) 537-4375

4951 S White Mountain Rd
Show Low, AZ 85901
Phone (928) 532-5848

4951 S White Mountain Rd
Bldg A
Show Low, AZ 85901
Phone (928) 537-6700

Interoperability endpoints

  • Direct secure messaging: sheridanporter@shrmcshma.allscriptsdirect.net

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.

Hospital & facility affiliations 4

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": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1962224790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "584 E GREER AVE",
            "city": "SNOWFLAKE",
            "state": "AZ",
            "postal_code": "859375172",
            "telephone_number": "928-228-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 S WHITE MOUNTAIN RD",
            "city": "SHOW LOW",
            "state": "AZ",
            "postal_code": "859017827",
            "telephone_number": "928-228-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "SHERIDAN",
        "middle_name": "LYNELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "316188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Show Low, AZ

Sources for this page

Verify at the official NPI Registry.