MEDICARE: DR. KENNETH W PORTER-SHIRLEY MD

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	207P00000X	Emergency Medicine Physician	200300682	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00184250	OTHER	NC	KENNETH-PORTER SHIRLEY
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	135XT	OTHER	NC	KENNETH PORTER-SHIRLEY

General Provider Information

NPI Number	:	1932104080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH W PORTER-SHIRLEY MD

Provider Business Mailing Address
First Line	:	159 PEARSON DR
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28801-1600
Country	:	US
Telephone Number	:	828-337-0326
Fax Number	:

Provider Business Practice Location Address
First Line	:	32 ORANGE ST
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28801-2341
Country	:	US
Telephone Number	:	828-771-5012
Fax Number	:	828-281-3164

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	08/12/2025

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