Individual provider Active NPI

Sheryl R. Porter, PH.D.

  • Psychologist
  • Overland Park, KS
National Provider Identifier
1982794384
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
659 Issued in KS
Practice address
7501 College Blvd.
Suite 250
Overland Park, KS 66210-1944
Phone
(913) 451-8550
Fax
(913) 469-5266
NPI assigned
Oct 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 659 KS Primary
Psychologist 103T00000X R0213 MO

Addresses

Primary practice location

7501 College Blvd.
Suite 250
Overland Park, KS 66210-1944

Mailing address

7501 College Blvd.
Suite 250
Overland Park, KS 66210-1944
Phone (913) 451-8550

Other identifiers 3

IdentifierTypeStateIssuer
100238770AMedicaidKS
13725011OtherKSBCBS KC
13725011OtherMOBCBS KC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
R0213MOMDPsychologist
659KSMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225843200000",
    "number": "1982794384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 COLLEGE BLVD.",
            "address_2": "SUITE 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101944",
            "telephone_number": "913-451-8550",
            "fax_number": "913-469-5266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 COLLEGE BLVD.",
            "address_2": "SUITE 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662101944",
            "telephone_number": "913-451-8550",
            "fax_number": "913-469-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "SHERYL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2008-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KS",
            "license": "659",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "R0213",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100238770A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "13725011",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS KC",
            "identifier": "13725011",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.