Active NPI
Benjamin Potter, DPM
- Foot & Ankle Surgery Podiatrist
- Kingsport, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 905
- Practice address
- 430 W Ravine Rd
Kingsport, TN 37660-3868 - Phone
- (423) 245-3161
- Fax
- (423) 245-8916
- NPI assigned
- Apr 9, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 905 | TN | Primary |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 135.001005 | IL | |
| Foot Surgery Podiatrist | 213ES0131X | 905 | TN |
Addresses
Primary practice location
430 W Ravine Rd
Kingsport, TN 37660-3868
Mailing address
1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111
Other practice location 1
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
111 W Stone Dr
Kingsport, TN 37660-6027
130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 230-8200
430 W Ravine Rd
Kingsport, TN 37660-3868
Phone (423) 245-3161
Hospital & facility affiliations
- Wellmont Holston Valley Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 29 |
| Removal of nail tissue | 15 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 135.001005 | IL | MD | Foot & Ankle Surgery Podiatrist |
| 905 | TN | MD | Foot Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmont Medical Associates, Inc. | Current | Accepting new patients | |
| Wellmont Medical Associates Inc | Current | Accepting new patients | |
| Wellmont Health System | Current | Accepting new patients | |
| Associated Orthopaedics of Kingsport PC | Current | Accepting new patients | |
| Associated Orthopaedics of Kingsport PC | Current | Accepting new patients | |
| Associated Orthopaedics of Kingsport PC | Past | Accepting new patients | |
| Blue Ridge Medical Management Corporation | Past | Accepting new patients |
Locations
1 Medical Park Blvd
Ste 300E
Bristol, TN 37620
Phone (423) 245-3161
1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565
111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197
430 W Ravine Rd
Kingsport, TN 37660
Phone (423) 245-3161
130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150
Interoperability endpoints
- bpotter283067@balladhealth.medalliesdirect.net
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1579
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Kingsport, TN
- NPI 1053683227
-
- Pulmonary Disease Physician
- Kingsport, TN
- NPI 1780986257
-
- Orthopaedic Surgery Physician
- Kingsport, TN
- NPI 1912437062
-
- General Acute Care Hospital
- Kingsport, TN
- NPI 1760405849
-
- Psychiatry Physician
- Johnson City, TN
- NPI 1275393522
-
- Cardiovascular Disease Physician
- Johnson City, TN
- NPI 1740227131
-
- Orthopaedic Surgery Physician
- Norton, VA
- NPI 1013273937
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771545600000",
"number": "1063919793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1021 W OAKLAND AVE STE 310",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376042192",
"telephone_number": "423-952-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 W RAVINE RD",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603868",
"telephone_number": "423-245-3161",
"fax_number": "423-245-8916"
}
],
"practiceLocations": [
{
"address_1": "130 W Ravine Rd",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376603837",
"country_code": "US",
"telephone_number": "423-224-4000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POTTER",
"first_name": "BENJAMIN",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-04-09",
"last_updated": "2026-02-20",
"certification_date": "2026-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "TN",
"license": "905",
"primary": true
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IL",
"license": "135.001005",
"primary": false
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "TN",
"license": "905",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.