John Wesley Porter, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP100482 Issued in ID

Practice address

3363 Merlin Dr
Idaho Falls, ID 83404-7405

Phone

(208) 523-0330

NPI assigned

Jul 17, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Iwasa Eye Center P.a.

  • Optometrist
  • Fruitland, ID
  • NPI 1346383957
  Medicare reassignment NPD
• Eyecare Center Idaho Falls LLC

  • Optometrist
  • Idaho Falls, ID
  • NPI 1568262111
  NPD
• Intermountain Eye and Laser Centers PLLC

  dba Intermountain Eye Centers

  • Glaucoma Specialist (Ophthalmology) Physician
  • Eagle, ID
  • NPI 1518643923

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1972089514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 LILLIAN MILLER PKWY STE 100",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762107206",
            "telephone_number": "940-891-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3363 MERLIN DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047405",
            "telephone_number": "208-523-0330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 N 2nd E Ste 1",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834401603",
            "country_code": "US",
            "telephone_number": "208-359-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PORTER",
        "first_name": "JOHN",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-17",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP100482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Porter, RDN
• Bailey Leigh Porter, MSOT, OTR/L
• Chad Michael Porter, LCSW
• Clayden Porter, LSW
• Emily Porter
• Kimberly Porter, LMSW
• Lisa L. Porter, O.D.
• Misty Porter
• Jason Michael Poston, MD
• Brynn Noel Potere

• Optometrist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.