Louis David Potyondy, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

MD 60288108 Issued in WA

Practice address

801 Pacific Ave
Tacoma, WA 98402-5209

Phone

(229) 589-2588

NPI assigned

May 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1104884956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025209",
            "telephone_number": "229-589-2588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984025209",
            "telephone_number": "229-589-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTYONDY",
        "first_name": "LOUIS",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "GA",
            "license": "057743",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WA",
            "license": "MD 60288108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "814916866A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001281100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PRACTICE NPI",
            "identifier": "1508824293",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer H Potter, DO
• Kenner Potter
• Kerry Potter
• Mark Blaine Potter, D.O.
• Rosangela Potter
• Donna Jeanne Poucel, M.D.
• Brenda Anne Pounds, REGISTERED NURSE
• Heather Catherine Pounds, ARNP
• Eileen Louise Poupore, NP
• Poya Pourghaderi, DO

• Plastic Surgery Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Plastic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.