Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan James Porter, DO

Individual provider Internal Medicine Physician · NPI 1194306126

Ethan James Porter, DO is a Hospitalist in Rolla, Missouri. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2021, 5 years ago. Practices with Pcrmc Medical Group Inc, a 114-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
5
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
MO
In the registry since
2021
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1000 W 10th St
Rolla, MO 65401-2905
Phone: (573) 364-9000
Fax: (573) 426-2108
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 1125 N College Ave # Slot100, Fayetteville, AR 72703-1908 — (479) 713-8700
  • 604 W 6th St Ste A, Rolla, MO 65401-2968 — (573) 364-9352
  • 1000 W 10th St, Rolla, MO 65401-2905 — (573) 458-8899

Specialties & licences

Hospitalist Physician (primary) Taxonomy 208M00000X · Licence 2024035388 (MO)
Internal Medicine Physician Taxonomy 207R00000X · Licence 2024035388 (MO)

Record details

NPI number1194306126
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 20, 2021
Last updated in NPPESAugust 6, 2026
Certification dateAugust 6, 2026
Mailing address1050 W 10th St, Rolla, MO 65401-2905

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyHOSPITALIST
Also practisesINTERNAL MEDICINE
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2021 (5 years in practice)
Group practice Pcrmc Medical Group Inc — 114 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Rolla