Active NPI
Robin Potter
- Clinical Psychologist
- Phoenix, AZ
National Provider Identifier
1023284551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3824
- Practice address
- 3747 N 24TH St
Phoenix, AZ 85016-6510 - Phone
- (602) 840-4962
- NPI assigned
- May 5, 2008
- Last updated
- Jun 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3824 | AZ | Primary |
Addresses
Primary practice location
3747 N 24TH St
Phoenix, AZ 85016-6510
Mailing address
3747 N 24TH St
Phoenix, AZ 85016-6510
Phone (028) 404-9626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 23, 2023 through Jun 23, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3824 | AZ | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Biltmore Psychology Services | Current | Accepting new patients |
Locations
3747 N 24th St
Phoenix, AZ 85016
Phone (602) 430-2337
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychologist
- Phoenix, AZ
- NPI 1700533098
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1023284551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3747 N 24TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850166510",
"telephone_number": "028-404-9626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3747 N 24TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850166510",
"telephone_number": "602-840-4962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "ROBIN",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-05",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AZ",
"license": "3824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.