KIM PORTER (NPI# 1457997850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457997850 |
| Entity Type | Individual |
| Full Name | KIM PORTER |
| Credential | RPH |
| Practice Address |
1522 Main Street Petersburg TX 79250 |
| Practice Telephone | 8066672231 |
| Practice Fax Number | 8066670170 |
| Mailing Telephone | 8066672231 |
| Mailing Fax Number | 8066670170 |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2019-11-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 20809 | TX | Pharmacy Service Providers |
| N | 333600000X | Pharmacy | 2350 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 140165 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255508677 | Kim Brown Porter | Psychologist | 10421 S Figueroa St, Los Angeles, CA 90003-4423 | 2008-05-14 |
| Street Address |
1522 MAIN STREET |
| City | PETERSBURG |
| State | TX |
| Zip Code | 79250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922549807 | Bonnie Cantu | Counselor | 2104 E 1st St, Petersburg, TX 79250 | 2017-03-13 |
| 1336266642 | Petersburg Isd | Local Education Agency (LEA) | 1411 West 4th Street, Petersburg, TX 79250 | 2007-03-23 |
| 1891885364 | Porter Drug | Pharmacy | 1522 Main, Petersburg, TX 79250 | 2006-10-13 |
| 1144329616 | City of Petersburg | Ambulance | 1501 Main, Petersburg, TX 79250 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124663 | Vets Aide | Home Health Aide | 49 Walnut Blvd, Petersburg, VA 23805-2109 | 2020-11-03 |
| 1720688419 | Kimberly Dawn Runion | Technician | 791 Cave Mtn Rd, Petersburg, WV 26847 | 2020-10-30 |
| 1740889872 | Tandrea Graham | Community Health Worker | 628 Old Wagner Rd, Petersburg, VA 23805-9319 | 2020-10-20 |
| 1235738394 | Hl Transportation Services LLC | Non-emergency Medical Transport (VAN) | 210 Walnut Blvd Apt 19, Petersburg, VA 23805-2054 | 2020-10-20 |
| 1265030217 | Alisha Rose Powell | Technician | 216 Clifftop Dr Apt 84, Petersburg, WV 26847-8893 | 2020-10-13 |
| 1063010155 | Kourtney Hendricks | Home Health Aide | 1641 Darby Dr, Petersburg, VA 23803-5331 | 2020-10-12 |
| 1396342895 | Stacey Reynolds Dahl | Nurse Practitioner | 103 Fram Treet, Petersburg, AK 99833-0589 | 2020-10-07 |
| 1174130397 | Upscale Home Care, LLC | Home Health | 325 Brown St Ste 131, Petersburg, VA 23803-4234 | 2020-09-30 |
| 1295341675 | Logan Mackenzie Willis | Technician | 216 Clifftop Dr Apt 86, Petersburg, WV 26847-8893 | 2020-09-21 |
| 1336755917 | Leap of Faith Adult Services LLC | Day Training, Developmentally Disabled Services | 528 Virginia Ave, Petersburg, VA 23803-5759 | 2020-09-19 |
| Find all providers in PETERSBURG | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659815322 | Mark Saville | Pharmacist | 86 Saullie Evans Dr, Petersburg, WV 26847-7014 | 2016-12-14 |
| 1851729495 | Fontellia Yates | Pharmacist | 1026 Dakar Dr, Petersburg, VA 23803-4804 | 2013-10-16 |
| 1881937761 | Catherine Kowalski | Pharmacist | 215 North Nordic Drive, Petersburg, AK 99833-1209 | 2013-03-29 |
| 1619247152 | Tina Stoll Graham | Pharmacist | 3280 S Crater Rd, Petersburg, VA 23805-9217 | 2011-12-30 |
| 1275822744 | Rite Aid Pharmacy | Pharmacist | 2141 S Crater Rd, Petersburg, VA 23805-2701 | 2011-04-05 |
| 1427356807 | Sharon Easton Kannegieter | Pharmacist | 4310 Westgate Rd, Petersburg, VA 23803-6571 | 2011-03-08 |
| 1912119868 | Michael Lamar Dupree | Pharmacist | Fcc Petersburg Medium Attn Pharmacy Svc, 1060 River Road Box 90042, Petersburg, VA 23804 | 2007-05-04 |
| 1275656738 | Elizabeth Mitchell Smith | Pharmacist | 3330 S Crater Rd, Petersburg, VA 23805-9277 | 2007-04-09 |
| 1104946342 | Erica Worhatch | Pharmacist | 215 North Nordic Dr, Petersburg, AK 99833 | 2007-03-30 |
| 1396880738 | John Edward Wall | Pharmacist | 26317 W. Washington Street Extended, Petersburg, VA 23803-0030 | 2007-02-21 |
| Find all providers in PETERSBURG | ||||
| City | PETERSBURG |
| Zip Code | 79250 |
Please comment or provide details below to improve the information on KIM PORTER.
| 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.