Daryl K Potter, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1028685 Issued in TX

Practice address

1507 W Main St
Gatesville, TX 76528-1024

Phone

(254) 865-2166

Fax

(254) 248-0626

NPI assigned

Feb 12, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coryell County Memorial Hospital AuthorityGroup PAC ID 7719886282, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Coryell Memorial Hospital Hospital, Gatesville, TX, CCN 451379
• Ascension Providence Hospital, Waco, TX, CCN 450042

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Coryell County Memorial Hospital Authority

  • Anesthesiology Physician
  • Gatesville, TX
  • NPI 1992832521
  Medicare reassignment Care Compare group NPD
• Coryell County Memorial Hospital Authority

  • Skilled Nursing Facility
  • Gatesville, TX
  • NPI 1427345347
  NPD
• Coryell County Memorial Hospital Authority

  • Emergency Medicine Physician
  • Gatesville, TX
  • NPI 1528195062
  NPD
• Mark Malone MD PA

  • Pain Medicine (Anesthesiology) Physician
  • Round Rock, TX
  • NPI 1407057250
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension Providence

  • General Acute Care Hospital
  • Waco, TX
  • NPI 1093708679
  Care Compare affiliation
• Coryell County Memorial Hospital Authority

  • Critical Access Hospital
  • Gatesville, TX
  • NPI 1780823021
  Care Compare affiliation

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1124442199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 W MAIN ST",
            "city": "GATESVILLE",
            "state": "TX",
            "postal_code": "765281024",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 W MAIN ST",
            "city": "GATESVILLE",
            "state": "TX",
            "postal_code": "765281024",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-0626"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5100 Franklin Ave",
            "address_purpose": "LOCATION",
            "city": "Waco",
            "state": "TX",
            "postal_code": "767106922",
            "country_code": "US",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-6306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 N Main St",
            "address_purpose": "LOCATION",
            "city": "McGregor",
            "state": "TX",
            "postal_code": "766571236",
            "country_code": "US",
            "telephone_number": "254-865-2166",
            "fax_number": "254-248-6306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "404 Avenue E",
            "address_purpose": "LOCATION",
            "city": "Moody",
            "state": "TX",
            "postal_code": "765573579",
            "country_code": "US",
            "telephone_number": "254-853-9603",
            "fax_number": "254-853-9612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTER",
        "first_name": "DARYL",
        "middle_name": "K",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-12",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP5387",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1028685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "898460",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpotter@ch.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Coryell Health Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "1507 W Main St",
            "city": "Gatesville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765281024",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dawn Marie Pessa, MSN, FNP-BC
• Tuyen Minh Pham, PHARM D
• Phillip Burress Yarbrough, FNP-C, PLLC
• David Michael Pinkstaff, MD
• Anthony Carey Podbielski, FNP-C
• Joanne E Pritchard, MD
• Kelley R Raley, PHARM.D.
• Real Life Services (RLS)
• Katherine E Rediske, MA, LPC
• Tracy Rhiner

• Family Nurse Practitioner in Gatesville, TX
• Providers in Gatesville, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.