WILLIAM C PORTER MD LTD (NPI# 1124058326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124058326 |
| Entity Type | Organization |
| Organization Name | WILLIAM C PORTER MD LTD |
| Practice Address |
100 4th St S Ste 608 Fargo ND 58103-1929 |
| Practice Telephone | 7012350161 |
| Practice Fax Number | 7012350332 |
| Mailing Telephone | 7012350161 |
| Mailing Fax Number | 7012350332 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2008-10-04 |
| Authorized Official Name | DR. WILLIAM CALVIN PORTER (PRESIDENT) |
| Authorized Official Telephone | 7012350161 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | 5644 | ND | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS MN | 2T995PO | 01 |
| ND | BCBS ND | 01167001 | 01 |
| Street Address |
100 4TH ST S STE 608 |
| City | FARGO |
| State | ND |
| Zip Code | 58103-1929 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720078405 | Mark Allan Schaffer | Dentist | 100 4th St S, Suite 312, Fargo, ND 58103-1929 | 2005-10-25 |
| 1386280261 | Canopy Medical Clinic, Pllc | Nurse Practitioner | 100 4th St S, Fargo, ND 58103-1929 | 2019-11-26 |
| 1437715166 | Diana Rose Slivensky | Psychologist | 100 4th St S, Fargo, ND 58103-1929 | 2019-05-17 |
| 1861945784 | Resolve Behavioral Health, LLC | Community/Behavioral Health | 100 4th St S, Fargo, ND 58103-1929 | 2016-07-27 |
| 1578927315 | Jason Cossette | Pharmacist | 100 4th St S, Fargo, ND 58103-1929 | 2016-04-07 |
| 1437521366 | Nicole A Kiewel | Clinical Neuropsychologist | 100 4th St S, Fargo, ND 58103-1929 | 2015-10-30 |
| 1821472143 | Angela M Lee | Nurse Practitioner | 100 4th St S, Fargo, ND 58103-1929 | 2015-07-16 |
| 1104231992 | Mustafa Abdulhusein | Psychiatry & Neurology | 100 4th St S, Fargo, ND 58103 | 2014-06-30 |
| 1609205988 | Robyn Maley | Psychologist | 100 4th St S, Fargo, ND 58103-1929 | 2013-11-06 |
| 1699102897 | Lindsey Marie Sloan Peterson | Nurse Practitioner | 100 4th St S, Fargo, ND 58103-1929 | 2013-10-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700944915 | Lesley A Soine | Otolaryngology | 2700 12th Ave S, Ste D, Fargo, ND 58103-8723 | 2006-12-04 |
| 1992803662 | Sue Karen Wink | Otolaryngology | 1800 21st Ave S, Fargo, ND 58103-5759 | 2006-09-20 |
| 1982606000 | Ferdinand Lavenuta | Otolaryngology | 1214 Oak St N, Fargo, ND 58102-2707 | 2005-06-01 |
| 1245585587 | Morgan Lien | Otolaryngology | 801 Broadway N, Fargo, ND 58102-3641 | 2012-07-23 |
| 1275858714 | Brent G Nichols | Otolaryngology | 801 Broadway N, Fargo, ND 58102-3641 | 2010-03-27 |
| 1720285323 | Andrew Michael Terrell | Otolaryngology | 801 Broadway N, Fargo, ND 58102-3641 | 2007-06-28 |
| 1942416714 | Matthew Walter Miller | Otolaryngology | 801 Broadway N, Fargo, ND 58122 | 2007-05-16 |
| 1447395512 | Michael J Shinners | Otolaryngology | 801 Broadway N, Fargo, ND 58102-3641 | 2007-02-20 |
| 1952469165 | Susan M Mathison | Otolaryngology | 1800 21st Ave S, Fargo, ND 58103 | 2006-12-04 |
| 1043378268 | Catalyst Medical Center PC | Otolaryngology | 1800 21st Ave S, Fargo, ND 58103 | 2006-12-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.