Jean Derek Potvin, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

DC-27513 Issued in CA

Practice address

24470 Del Prado
Dana Point, CA 92629-2739

Phone

(949) 488-0348

NPI assigned

Nov 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Todoroff and Chapman a Professional Corporation

  • Physical Medicine & Rehabilitation Physician
  • Vista, CA
  • NPI 1396076790
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124194345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24470 DEL PRADO",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926292739",
            "telephone_number": "949-488-0348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24470 DEL PRADO",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926292739",
            "telephone_number": "949-488-0348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTVIN",
        "first_name": "JEAN",
        "middle_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC-27513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Perrine, ND
• William Loftin Petersen, O.D.
• Kelsey Pham, BCBA
• Mandy Pham
• Stephen E Pituck, M.D.
• Bradley B Powell, DC
• Gabrielle Powers, L.C.S.W
• Prendiville Properties, Inc.
• Kevin J Prendiville, M.D.
• Preventativerx

• Sports Physician Chiropractor in Dana Point, CA
• Providers in Dana Point, CA by specialty
• Sports Physician Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.