Shannon Elizabeth Potter, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Newfields, NH
NPI 1033824693 · NPPES record last updated May 15, 2024
Key facts
- NPI
- 1033824693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 080466-21 (NH)
- Practice address
- 1 Railroad Ave
Newfields, NH 03856-8406 - Phone
- (603) 810-0002
- Fax
- (603) 772-3601
- NPI assigned
- Jan 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230912001352 | NH | Practitioner - Nurse Practitioner | 6608230552 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 080466-21 | NH | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Convenientmd - FFS UC LLC | Single Specialty | Current |
Accepting new patients |
| Convenientmd - FFS UC LLC | Single Specialty | Current | Accepting new patients |
| Convenientmd - FFS UC LLC | Current |
Accepting new patients | |
| Convenientmd - FFS UC LLC | Single Specialty | Past | Accepting new patients |
Locations
3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700
360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700
1 Portsmouth Ave
Stratham, NH 03885
Phone (603) 772-3600
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse |
163W00000X | 080466-21 | NH | |
| Family Nurse Practitioner | 363LF0000X | 080466-21 | NH | Yes |
Addresses
Primary practice location
1 Railroad Ave
Newfields, NH 03856-8406
Mailing address
1 Railroad Ave
Newfields, NH 03856-8406
Phone (603) 810-0002
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://www.drchrono.com/electronic-health-record-ehr/ |
Other providers in Newfields, NH
- DBT for You
- Sam Kistler Harmon
- Kristin S. Keenan
- Kelley Corson Licsw LLC
- Kristin Keenan, P.T.
- Thomas Shea
- Catherine Elise Tarnowski
- Suzanne M White
All providers in Newfields, NH · Family Nurse Practitioner in New Hampshire
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.