Joanna Potter, RD
Individual provider Active NPI Registered Dietitian · Palmersville, TN
NPI 1033569066 · NPPES record last updated Jun 21, 2016
Key facts
- NPI
- 1033569066
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 800441
- Practice address
- 11634 Latham Highway 190
Palmersville, TN 38241-5234 - Phone
- (731) 822-3828
- NPI assigned
- Jun 21, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDN0000002189 | TN | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LDN0000002189 | TN | |
| Registered Dietitian | 133V00000X | 800441 | Yes |
Addresses
Primary practice location
11634 Latham Highway 190
Palmersville, TN 38241-5234
Mailing address
11634 Latham Highway 190
Palmersville, TN 38241-5234
Phone (731) 822-3828
Other providers in Palmersville, TN
All providers in Palmersville, TN · Registered Dietitian in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.