Ann Elizabeth Potter, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

279 Issued in NE

Practice address

12822 Augusta Avenue
Omaha, NE 68144

Phone

(402) 403-0190

Fax

(402) 932-4121

NPI assigned

Jan 13, 2006

Last updated

Aug 29, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NE

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Attachment and Trauma Center of Nebraska LLCGroup PAC ID 5092879148, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Attachment and Trauma Center of Nebraska, LLC

  • Mental Health Counselor
  • Omaha, NE
  • NPI 1881866929
  Medicare reassignment Care Compare group Authorized official
• Therapy Resource Associates, Inc.

  • Counselor
  • Omaha, NE
  • NPI 1306872817

  Clinical

  NPD (past)

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1063491413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12822 AUGUSTA AVENUE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68144",
            "telephone_number": "402-403-0190",
            "fax_number": "402-932-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12822 AUGUSTA AVENUE",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68144",
            "telephone_number": "402-403-0190",
            "fax_number": "402-932-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "ANN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NE",
            "license": "279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEGELLAN",
            "identifier": "600509097",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08382",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "08382",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Potmesil
• Kathryn Potocek
• Jenna Marie Potratz
• Mallory Leigh Pottebaum, PA-C
• Aleshia Potter
• David Potter
• Elizabeth Ann Potter, LMHP
• Jane Potter, MS,LMSW, LISW, LIMHP
• Jane F Potter, MD
• Jennifer Elizabeth Potter

• Clinical Psychologist in Omaha, NE
• Providers in Omaha, NE by specialty
• Clinical Psychologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.