John Roger Potter, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

17883 Issued in KY

Practice address

700 13TH St
Ashland, KY 41101

Phone

(606) 329-0204

Fax

(606) 324-7770

NPI assigned

Oct 2, 2006

Sex

Male

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 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jpotter9554@direct.kdhealth.us

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.

• Ashland Children'S Clinic

  • Pediatrics Physician
  • Ashland, KY
  • NPI 1609931658
  NPD (past) Authorized official

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1144314659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 13TH ST",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "41101",
            "telephone_number": "606-329-0204",
            "fax_number": "606-324-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 13TH ST",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "41101",
            "telephone_number": "606-329-0204",
            "fax_number": "606-324-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "JOHN",
        "middle_name": "ROGER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "17883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0406617",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC SUPER BLUE PLUS",
            "identifier": "336109752062212",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65917544",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "22000000063411",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0110220000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64178833",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT ST BC/BS",
            "identifier": "610975206003",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC PPO",
            "identifier": "6109752062212",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC PROVIDER",
            "identifier": "000000062599",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "12-029969",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Porter
• Dwain Phillip Porter, D.C.
• Lori Porter, OT
• Morgan Porter
• Portsmouth Ambulance Inc
• Judy Potter, CRNA
• Lisa Ann Potter, DEVELOPMENTAL INTERV
• Donna Powell, RNFA
• Yogendra Prasad, MD
• Gary V Prater, PSY D

• Pediatrics Physician in Ashland, KY
• Providers in Ashland, KY by specialty
• Pediatrics Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.