Stacy L Potter

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

Practice address

529 Lester Rd
Fayetteville, GA 30215-5248

Phone

(404) 425-3780

Fax

(404) 425-3780

NPI assigned

Aug 23, 2025

Sex

Unspecified or another gender identity

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1755907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755907200000",
    "number": "1033097597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 LESTER RD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302155248",
            "telephone_number": "404-425-3780",
            "fax_number": "404-425-3780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "STACY",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-08-23",
        "last_updated": "2025-08-23",
        "certification_date": "2025-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yolanda Polk
• Arvind Jayaraj Ponnambalam, MD
• David Michael Popoli, M.D.
• Scharmane Porter
• Tiffany Porter
• Potts and Smith Pediatrics
• Potts Pediatrics and Adolescent Medicine and Prevenatative Care LLC
• John M Potts, MD
• Adrian Powe
• Erin Powell

• Surgical Assistant in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Surgical Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.