Deborah Krist Potticary

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5011655 Issued in NC

Practice address

3333 Silas Creek Pkwy
Winston Salem, NC 27103-3013

Phone

(336) 718-7041

Fax

(336) 718-9622

NPI assigned

Feb 9, 2017

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Novant Health Thomasville Medical Center LLCGroup PAC ID 5890605224, 101 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Thomasville Medical Center Hospital, Thomasville, NC, CCN 340085

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpotticary722707@direct.novanthealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Novant Health Thomasville Medical Center, LLC

  • Specialist
  • Thomasville, NC
  • NPI 1033160205
  Medicare reassignment Care Compare group NPD
• Novant Health Medical Group, LLC

  • Neurology with Special Qualifications in Child Neurology Physician
  • Charlotte, NC
  • NPI 1366409492
  Medicare reassignment NPD
• Hartford Hospital

  • Surgery Physician
  • Hartford, CT
  • NPI 1407806391
  Medicare reassignment NPD
• Hartford Hospital

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1770696643
  Medicare reassignment NPD
• Novant Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Matthews, NC
  • NPI 1386506137
  NPD
• Novant Health Medical Group, LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Winston Salem, NC
  • NPI 1457792921
  NPD
• Novant Health Thomasville Medical Center LLC

  • Hematology & Oncology Physician
  • Winston Salem, NC
  • NPI 1649159609
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Novant Health Thomasville Medical Center, LLC

  • General Acute Care Hospital
  • Thomasville, NC
  • NPI 1801848767
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1013455039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "336-718-7041",
            "fax_number": "336-718-9622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 SILAS CREEK PKWY",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033013",
            "telephone_number": "336-718-7041",
            "fax_number": "336-718-9622"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Seymour St",
            "address_2": "Palliative Care",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061063315",
            "country_code": "US",
            "telephone_number": "860-977-8433",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTICARY",
        "first_name": "DEBORAH",
        "middle_name": "KRIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-09",
        "last_updated": "2020-10-26",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "6946",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5011655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpotticary722707@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "80 Seymour St",
            "address_2": "Palliative Care",
            "city": "Hartford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "061063315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Positive Innovated Beginnings, LLC
• Alexis Marie Pothuraju, PA-C
• Tejit Venkata Pothuraju
• Lawrence H. Potter Jr., MD
• Deepa Retnem Potti, M.D.
• Melinda Sue Potts-Trippe, LMBT #101
• Barbara H Potts, PH.D
• Kimber Leann Potts, NP-C
• Stephen Bradley Potts, MD
• Alex Powell

• Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.