Physician Compare National (NPI:1306247747)

HEALTHCARE PROVIDER: SARAH EMMA PORTER PSYD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1306247747
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8224258629
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160321002381
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PORTER
	Individual professional last name
Provider First Name	SARAH
	Individual professional first name
Provider Middle Name	E.
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	6510 GRAND TETON PLZ
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	MADISON
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	537191029
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y