Individual provider Active NPI

Debra A Porter, DC

  • Chiropractor
  • Marietta, GA
National Provider Identifier
1962543066
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
005756 Issued in GA
Practice address
2655 Dallas Hwy SW
Suite 110
Marietta, GA 30064-2597
Phone
(770) 427-1889
Fax
(770) 427-7513
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 005756 GA Primary

Addresses

Primary practice location

2655 Dallas Hwy SW
Suite 110
Marietta, GA 30064-2597

Mailing address

2655 Dallas Hwy SW
Suite 110
Marietta, GA 30064-2597
Phone (770) 427-1889

Other identifiers 4

IdentifierTypeStateIssuer
646983OtherGAAMERICAN CHIROPRACTIC NET
52650137OtherGABLUECROSSBLUESHIELD OF GA
5707692OtherGAAETNA
1001532OtherGAAM.SPECIALTY NETWORK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040311000557 GA Practitioner - Chiropractic 8224926126 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2655 Dallas Hwy SW
Suite 110
Marietta, GA 30064-2597
Phone (770) 427-1889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005756GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Porter Family Chiropractic Center Chiropractor CurrentSince Jan 1, 1997 Accepting new patients

Locations

2655 Dallas Hwy SW
Ste 110
Marietta, GA 30064
Phone (770) 427-1889

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962543066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 DALLAS HWY SW",
            "address_2": "SUITE 110",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300642597",
            "telephone_number": "770-427-1889",
            "fax_number": "770-427-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 DALLAS HWY SW",
            "address_2": "SUITE 110",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300642597",
            "telephone_number": "770-427-1889",
            "fax_number": "770-427-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "DEBRA",
        "middle_name": "A",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "005756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN CHIROPRACTIC NET",
            "identifier": "646983",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD OF GA",
            "identifier": "52650137",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5707692",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AM.SPECIALTY NETWORK",
            "identifier": "1001532",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.