MR. MARK L. PORTER (NPI# 1457478828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457478828 |
| Entity Type | Individual |
| Full Name | MR. MARK L. PORTER |
| Credential | ATC |
| Practice Address |
4381 S Eason Blvd Tupelo MS 38801-6583 |
| Mailing Address |
Po Box 2252 Tupelo MS 38803-2252 |
| Practice Telephone | 6623775469 |
| Mailing Telephone | 6622315615 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT0337 | MS | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346395522 | Mark Robert Porter | Counselor | 212 E. 8th St., Fremont, NE 68025 | 2007-01-25 |
| 1508891615 | Mark Anthony Porter | Dentist | 18730 Stone Oak Pkwy, Suite 200, San Antonio, TX 78258-4140 | 2006-07-11 |
| 1902313489 | Mark Edward Porter | Counselor | 2140 Merced St, Fresno, CA 93721-1721 | 2018-01-05 |
| 1871970301 | Mark Porter | Student in an Organized Health Care Education/Training Program | 200 N Wolfe St, Baltimore, MD 21287-0011 | 2015-05-05 |
| 1538572102 | Mark Porter | Developmental Therapist | 321 Fortune Blvd, Milford, MA 01757-1750 | 2014-06-11 |
| 1821267063 | Mark Porter | Psychologist | 1 S School Ave, Sarasota, FL 34237-6014 | 2008-02-21 |
| 1528289717 | Mark Wilkin Porter | Perfusionist | 600 Mary St, Evansville, IN 47747 | 2007-05-02 |
| 1275669798 | Mark F Porter | Dentist | 212 E Market St, Troy, IL 62294-1512 | 2007-02-26 |
| 1285714402 | Mark Porter | Orthopaedic Surgery | 3530 E Spaulding Ave, Pueblo, CO 81008-2209 | 2006-10-16 |
| 1346232634 | Mark A. Porter | Psychiatry & Neurology | 200 S Herlong Ave, Suite H, Rock Hill, SC 29732-1182 | 2005-08-22 |
| Street Address |
4381 S EASON BLVD |
| City | TUPELO |
| State | MS |
| Zip Code | 38801-6583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548259013 | Donna Elaine Wesley | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2005-10-18 |
| 1013462258 | Millicent Mcalilly | Social Worker | 4381 S Eason Blvd, Suite 301, Tupelo, MS 38801-6583 | 2016-08-17 |
| 1679943401 | Jeffrey Dews | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2015-10-06 |
| 1013385715 | North Mississippi Medical Center, Inc. | Internal Medicine | 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801-6583 | 2015-09-11 |
| 1588046155 | Devin Fancher | Nurse Practitioner | 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801-6583 | 2015-06-19 |
| 1205249471 | Lori Hall Forrester | Nurse Practitioner | 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801-6583 | 2014-06-05 |
| 1003233727 | Michelle Pruitt | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2014-03-19 |
| 1518393354 | North Mississippi Medical Center, Inc. | Neurological Surgery | 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801-6583 | 2013-09-25 |
| 1497091730 | North Mississippi Medical Center, Inc | Nurse Practitioner | 4381 S Eason Blvd, Suite 201, Tupelo, MS 38801-6583 | 2012-12-13 |
| 1790034254 | Lee Ann Stewart | Physical Therapist | 4381 S Eason Blvd, Tupelo, MS 38801 | 2012-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1003443458 | Nicole Sherice Taylor | Nurse Practitioner | 845 South Gloster Street, Tupelo, MS 38801 | 2020-03-25 |
| 1821556838 | Wilco Healthcare of North Mississippi, Pllc | Point of Service | 1514 Co Rd 41, Tupelo, MS 38801 | 2019-03-08 |
| 1821565235 | Stephanie K Cagle | Nurse Practitioner | 218 S Thomas St Ste 120-121, Tupelo, MS 38801 | 2018-10-24 |
| 1073092326 | Lauren Parrish | Nurse Practitioner | 1573 Medical Park Circle, Tupelo, MS 38801 | 2018-08-08 |
| 1467948687 | North Mississippi Medcial Center, Inc. | Nurse Practitioner | 990 S Madison St Ste 2, Tupelo, MS 38801 | 2018-07-11 |
| 1043700933 | Hooks Diabetes & Medicine Clinic | Non-Pharmacy Dispensing Site | 2610 Traceland Drive, Ste A, Tupelo, MS 38801 | 2018-05-16 |
| 1073035903 | Annette C Riddle | Counselor | 1004 Eisenhower Drive, Tupelo, MS 38801 | 2017-07-12 |
| 1548709678 | Jaime Summers | Nurse Practitioner | 2780 West Jackson St, Tupelo, MS 38801 | 2017-02-22 |
| 1073975611 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 1168 Cross Creek Drive, Tupelo, MS 38801 | 2016-03-23 |
| Find all providers in zip 38801 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730726530 | Stephen Thompson | Specialist/Technologist | 2816 Jim St, Tupelo, MS 38801-6763 | 2019-11-30 |
| 1194257519 | Andrew Yim | Specialist/Technologist | 2479 Cressant St, Tupelo, MS 38801-3060 | 2017-04-03 |
| 1548259013 | Donna Elaine Wesley | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2005-10-18 |
| 1841721883 | Brandon Grecinger | Specialist/Technologist | 830 S Gloster St, Tupelo, MS 38801-4934 | 2017-03-22 |
| 1679943401 | Jeffrey Dews | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2015-10-06 |
| 1003233727 | Michelle Pruitt | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2014-03-19 |
| 1437352853 | Amy Michelle Whitley | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2007-06-06 |
| 1366645558 | Matthew Weisenberger | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2007-06-06 |
| 1881602449 | Chad Barker | Specialist/Technologist | 1743 Cliff Gookin Blvd, Tupelo, MS 38801-6723 | 2006-08-03 |
| 1447236195 | Walter Rufus Wilkins IIi | Specialist/Technologist | 4381 S Eason Blvd, Tupelo, MS 38801-6583 | 2005-12-15 |
| Find all providers in TUPELO | ||||
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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.