REX PORTE, MD - NPI NUMBER 1801235783

Summary

Provider Name: REX PORTE, MD

NPI Number: 1801235783

Clasification: Student in an Organized Health Care Education/Training Program (390200000X)

Address:
1125 N COLLEGE AVE
FAYETTEVILLE, AR
ZIP 72703

Phone Number: (479) 713-8000



Detailed Information

Rex Porte, MD is a student in an organized health care education/training program in Fayetteville, AR. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. The assigned NPI number for this provider is 1801235783 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

1125 N COLLEGE AVE
FAYETTEVILLE, AR
ZIP 72703-908
Phone: (479) 713-8000

The enumeration date for this NPI number is 6/24/2013 and was last updated on 7/17/2014.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 390200000X Student in an Organized Health Care Education/Training Program Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1801235783 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name PORTE The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name REX The first name of the provider, if the provider is an individual.
5 Provider Credential Text MD The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
6 Provider First Line Business Practice Location Address 1125 N COLLEGE AVE The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name FAYETTEVILLE The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name AR The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 727031908 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 4797138000 The telephone number associated with the location address of the provider being identified.
12 Provider Enumeration Date 6/24/2013 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 7/17/2014 The date that a record was last updated or changed.
14 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
15 Healthcare Provider Taxonomy Code 1 390200000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
16 Healthcare Provider Primary Taxonomy Switch 1 Y
17 Is Sole Proprietor Y Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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