MEDICARE: SHELDON DAWN PORTER RRT,RCP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2278G1100X	General Care Certified Respiratory Therapist	A-4675	NC
2	227900000X	Registered Respiratory Therapist	A-4975	NC
3	2279E1000X	Educational Registered Respiratory Therapist	A-4675	NC
4	2279H0200X	Home Health Registered Respiratory Therapist	A-4675	NC
5	2279P1004X	Pulmonary Diagnostics Registered Respiratory Therapist	A-4675	NC
6	2279P4000X	Patient Transport Registered Respiratory Therapist	A-4675	NC

General Provider Information

NPI Number	:	1720352560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELDON DAWN PORTER RRT,RCP

Provider Business Mailing Address
First Line	:	6345 MONTERREY CREEK DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-6225
Country	:	US
Telephone Number	:	919-943-6640
Fax Number	:

Provider Business Practice Location Address
First Line	:	6345 MONTERREY CREEK DR
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27713-6225
Country	:	US
Telephone Number	:	919-943-6640
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2012
Last Update Date	:	02/24/2012

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