DERRICK PORTER (NPI# 1962808824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962808824 |
| Entity Type | Individual |
| Full Name | DERRICK PORTER |
| Practice Address |
3101 S Gulley Rd Ste F Dearborn MI 48124-4406 |
| Mailing Address |
136 William St Springfield MA 01105-2324 |
| Practice Telephone | 7344072500 |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2014-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246Z00000X | Specialist/Technologist, Other | MI | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609215276 | Derrick Scott Porter | Internal Medicine | 2300 Miami Valley Dr Ste 310, Dayton, OH 45459-1294 | 2013-06-17 |
| 1760406938 | Derrick Allen Porter | Technician | 20188 W Vanzant Rd, Springdale, AR 72764-8978 | 2006-07-27 |
| 1245517341 | Derrick Allen Porter | Social Worker | 1441 E 84th Pl, Merrillville, IN 46410-6451 | 2011-11-03 |
| Street Address |
3101 S GULLEY RD STE F |
| City | DEARBORN |
| State | MI |
| Zip Code | 48124-4406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164599544 | Futures Healthcore, LLC | Speech-Language Pathologist | 3101 S Gulley Rd, Suite F, Dearborn, MI 48124-4406 | 2006-11-29 |
| 1871029215 | Chelsea Hunter- Flores | Speech-Language Pathologist | 3101 S Gulley Rd, Suite F, Dearborn, MI 48124-4406 | 2017-05-04 |
| 1376078675 | Mary Cooper | Occupational Therapist | 3101 S Gulley Rd, Suite F, Dearborn, MI 48124-4406 | 2017-04-24 |
| 1699214874 | Cathleen Nolan | Social Worker | 3101 S Gulley Rd, Ste F-g, Dearborn, MI 48124-4406 | 2017-02-21 |
| 1245776624 | Lila Dabaja | Speech-Language Pathologist | 3101 S Gulley Rd, Ste F, Dearborn, MI 48124-4406 | 2017-01-10 |
| 1194274126 | Soya Thomas | Physical Therapist | 3101 S Gulley Rd, Ste F, Dearborn, MI 48124-4406 | 2016-10-03 |
| 1114474608 | Katie Michalak | Speech-Language Pathologist | 3101 S Gulley Rd, Ste F, Dearborn, MI 48124-4406 | 2016-09-01 |
| 1447707047 | Amber Ray | Occupational Therapist | 3101 S Gulley Rd, Ste F, Dearborn, MI 48124-4406 | 2016-09-01 |
| 1386190106 | Suman Panda | Speech-Language Pathologist | 3101 S Gulley Rd, Ste F, Dearborn, MI 48124-4406 | 2016-08-31 |
| 1699123489 | Amanda Kokas | Occupational Therapist | 3101 S Gulley Rd, Ste F, Dearborn, MI 48124-4406 | 2016-06-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396389524 | Pharma A, LLC | Pharmacy | 23916 Michigan Ave, Dearborn, MI 48124 | 2019-10-31 |
| 1225683725 | Aysha Said | Behavior Technician | 1369 Porter St, Dearborn, MI 48124 | 2019-08-02 |
| 1881257772 | Leen Nusairat | Internal Medicine | Beaumont Health-dearborn Campus, 18101 Oakwood Blvd, Dearborn, MI 48124 | 2019-04-17 |
| 1417413360 | Gary C. Veraghen, Dds, PC | Dentist | 22100 W. Outer Drive, Dearborn, MI 48124 | 2019-02-15 |
| 1982168787 | Fnu Asma Manzar | Physical Therapist | Global Physical Therapy Services, Inc, 22819 Michigan Avenue, Dearborn, MI 48124 | 2019-01-25 |
| 1639640162 | Jernia Lashawn Usher | Behavior Technician | 1360 Porter St Lower Level, Dearborn, MI 48124 | 2018-12-10 |
| 1710456470 | Samar Fouad Hannawi | Psychologist | 3815 Pelham Street, Suite #13, Dearborn, MI 48124 | 2018-11-24 |
| 1881178747 | Sarah Chehab | Psychologist | 835 Mason St Suite 220b, Dearborn, MI 48124 | 2018-09-17 |
| 1568948289 | Ibrahim M Basma | Pharmacist | 22521 Michigan Avenue, Dearborn, MI 48124 | 2018-07-16 |
| 1669961942 | Jacqueline E Domzalski | Technician, Other | 3231 S. Gulley, Suite E, Dearborn, MI 48124 | 2018-05-02 |
| Find all providers in zip 48124 | ||||
| Taxonomy Code | 246Z00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831558659 | Theresa Ward | Specialist/Technologist, Other | 3231 S Gulley Rd, Suite E, Dearborn, MI 48124-4407 | 2016-02-22 |
| 1003275835 | Duaa Al-khafaji | Specialist/Technologist, Other | 3231 S Gulley Rd, Suite E, Dearborn, MI 48124-4407 | 2016-02-22 |
| 1881062412 | Clarissa Santana | Specialist/Technologist, Other | 3231 S Gulley Rd, Suite E, Dearborn, MI 48124-4407 | 2015-09-14 |
| 1376949891 | Althea Talbert | Specialist/Technologist, Other | 3101 S Gulley Rd, Ste F, Dearborn, MI 48124-4406 | 2014-11-11 |
| 1831595354 | Lydia Perry | Specialist/Technologist, Other | 3101 S Gulley Rd, Ste F, Dearborn, MI 48124-4406 | 2014-11-11 |
| 1659777324 | Ahmed Alroubi | Specialist/Technologist, Other | 3101 S Gulley Rd, Ste F, Dearborn, MI 48124-4406 | 2014-11-07 |
| 1376949024 | Kinyatta Walls | Specialist/Technologist, Other | 3101 S Gulley Rd, Ste F, Dearborn, MI 48124-4406 | 2014-11-07 |
| 1902200983 | Sahar Fawaz | Specialist/Technologist, Other | 3101 S Gulley Rd, Ste F, Dearborn, MI 48124-4406 | 2014-10-20 |
| 1528462181 | Shanice Brown | Specialist/Technologist, Other | 3101 S Gulley Rd, Dearborn, MI 48124-4406 | 2014-10-10 |
| 1033513601 | Joumana Amine | Specialist/Technologist, Other | 3101 S Gulley Rd, Dearborn, MI 48124-4406 | 2014-10-10 |
| Find all providers in DEARBORN | ||||
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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.