P Praxis·MD
● Active Type 1 · Individual

Dustin Blake Porter

Surgery·Burley, ID· NPI 1205178399 · Enumerated 2013 · 13 years on NPI
Porter is 1 of 3 surgery providers in Burley and 1 of 260 in Idaho.
NPI age
13 years
Enumerated 2013-03-26
Primary specialty
Surgery
Plus 1 subspecialty
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2026-03-03
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 260 active surgery providers in Idaho.

NPI age
13 years
↓ 5 yr below median (18 yr)
State licenses
1 state
28% of peers hold multiple states
Subspecialties
1
In the 37% of peers with subspecialties

NPI lifetime · 2013 → 2026

2013-03Enumerated in NPPES
2013 2026

Where they practice

Practice location
1501 Hiland Ave Ste H
Burley, ID 833182688
📞 2086776082
Mailing address
Po Box 30180
Salt Lake City, UT 841300180

Additional practice locations

1 secondary location on file with NPPES.

Location 2
550 S Jackson St, Room A2j21
Louisville, KY 402021622
📞 5028526191

Specialties

  • Surgery Primary
    A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and...
    ID license #M-14207 taxonomy 208600000X
  • Student in an Organized Health Care Education/Training Program
    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.
    taxonomy 390200000X

Practice context

Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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