KIRK PORTER (NPI# 1366801870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1366801870 |
Entity Type | Individual |
Full Name | KIRK PORTER |
Credential | P.A.-C. |
Practice Address |
1107 E Matthews Ave Suite 200 Jonesboro AR 72401-4315 |
Practice Telephone | 8709314442 |
Practice Fax Number | 8708020205 |
Mailing Telephone | 8709314442 |
Mailing Fax Number | 8708020205 |
Enumeration Date | 2016-02-12 |
Last Update Date | 2016-11-09 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PT2016-011 | AR | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | 212903795 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689987679 | Kirk I. Porter | Social Worker | 4531 Se Belmont St Ste 250, Portland, OR 97215-1675 | 2010-07-19 |
Street Address |
1107 E MATTHEWS AVE SUITE 200 |
City | JONESBORO |
State | AR |
Zip Code | 72401-4315 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629037585 | Wendy Leigh Spanos | Family Medicine | 1107 E Matthews Ave, Suite 103, Jonesboro, AR 72401-4315 | 2006-03-20 |
1275014409 | Lindsey Blair Johnson | Nurse Practitioner | 1107 E Matthews Ave, Jonesboro, AR 72401 | 2018-08-26 |
1770906521 | Tracie Norris | Physical Therapist | 1107 E Matthews Ave, Ste. 100, Jonesboro, AR 72401-4315 | 2014-01-30 |
1346473139 | Tracy Jones Physical Therapy Services, P.a. | Clinic/Center | 1107 E Matthews Ave, Suite 100, Jonesboro, AR 72401-4315 | 2009-08-27 |
1225185002 | Tracy Jones | Physical Therapist | 1107 E Matthews Ave, Suite 100, Jonesboro, AR 72401-4315 | 2007-01-04 |
1457314577 | Ronald E South | Psychiatry & Neurology | 1107 E Matthews Ave, Suite 200, Jonesboro, AR 72401-4315 | 2006-04-10 |
1043273568 | Mario Cauli | Psychiatry & Neurology | 1107 E Matthews Ave, Suite 200, Jonesboro, AR 72401-4315 | 2006-04-07 |
1932162591 | Demetrius S. Spanos | Psychiatry & Neurology | 1107 E Matthews Ave, Suite 200, Jonesboro, AR 72401-4315 | 2006-04-06 |
1174585061 | Neurology Associates of Northeast Arkansas Pa | Psychiatry & Neurology | 1107 E Matthews Ave, Suite 200, Jonesboro, AR 72401-4315 | 2006-04-05 |
1144280876 | William Russell Morgan | Dentist | 1107 E Matthews Ave, Suite 101, Jonesboro, AR 72401-4315 | 2006-03-25 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
Find all providers in zip 72401 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184250805 | Ashley Elizabeth Mclean | Physician Assistant | 225 E Washington Ave, Jonesboro, AR 72401-3111 | 2020-03-13 |
1063968022 | Rebecca Mcphail | Physician Assistant | 7823 Spivey Station Blvd, Jonesboro, GA 30236-2886 | 2016-08-30 |
1548629090 | Adam Lawson | Physician Assistant | 103 Watts St, Jonesboro, LA 71251-2053 | 2016-02-12 |
1326419789 | Mandy Katheryn Mcnamara | Physician Assistant | 103 Watts St, Jonesboro, LA 71251-2053 | 2015-10-12 |
1598153157 | Drew Weldon Harper | Physician Assistant | 4802 E Johnson Ave, Jonesboro, AR 72401-8413 | 2015-01-06 |
1053650945 | Meredith Harrison Brewer | Physician Assistant | 800 S Church St Ste 203, Jonesboro, AR 72401 | 2013-02-12 |
1346587599 | Maranda Elizabeth Nichols | Physician Assistant | 4334 E Highland Dr, Ste A, Jonesboro, AR 72401-6621 | 2013-01-08 |
1194025536 | Linda Nguyen | Physician Assistant | 300 Carson St, Jonesboro, AR 72401-3104 | 2010-11-02 |
1043311376 | Jerome A Maislis | Physician Assistant | 2400 Mt. Zion Parkway, Kaiser Permanente Southwood Comprehensive Medical Cente, Jonesboro, GA 30236 | 2006-09-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093271082 | Megan Breanna Albers | Physician Assistant | 100 Broadhurst St, Siloam Springs, AR 72761-4081 | 2019-02-14 |
1982115218 | Tabitha Jaggers | Physician Assistant | 1000 Hwy 35 N Ste 8, Benton, AR 72019-2353 | 2017-10-13 |
1801279575 | Rachel Fritsche Gordon | Physician Assistant | Northwest Health Urgent Care-siloam Springs, 3721 Us-412, Siloam Springs, AR 72761 | 2015-06-30 |
1700281938 | Carol J Trana | Physician Assistant | 4301 West Markham St, #748, Little Rock, AR 72205-7199 | 2014-10-30 |
1790011005 | Cassandra Lynn Ganus | Physician Assistant | 205 E Race Ave, Searcy, AR 72143-4329 | 2009-10-20 |
1699008672 | Robin Lynn Isaacks | Physician Assistant | 821 East Park Street, Highway 70, Carlisle, AR 72024 | 2009-09-09 |
1194966374 | Daniel Shane Briley | Physician Assistant | 2125 E Main St Ste 10, Siloam Springs, AR 72761-5576 | 2009-03-17 |
1619128360 | Stacie Renee Smith | Physician Assistant | 47 Hwy 64 W, Beebe, AR 72012-9500 | 2008-09-30 |
1861669541 | Gregory D Mills | Physician Assistant | 300 East Main, Swifton, AR 72471-0000 | 2008-05-13 |
1194990366 | Michelle Lee Manthe | Physician Assistant | 1615 W Persimmon St Ste B, Rogers, AR 72756-3383 | 2008-04-28 |
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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.