Individual provider Active NPI

Kent Potter, DO

  • Emergency Medicine Physician
  • Wichita, KS
National Provider Identifier
1164512315
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0425218 Issued in KS
Practice address
550 N Hillside St
Wichita, KS 67214-4910
Phone
(316) 962-2239
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0425218 KS Primary

Addresses

Primary practice location

550 N Hillside St
Wichita, KS 67214-4910

Mailing address

PO Box 548
Wichita, KS 67201-0548
Phone (316) 962-2239

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040419000076 KS Practitioner - Emergency Medicine 5092700187 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0425218KSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital District No 6 of Harper County, Kansas CurrentSince Apr 19, 2022 Accepting new patients
Hospital District No 6 of Harper County Kansas Current Accepting new patients
Carepoint Emergency Medicine Kansas LLC Emergency Medicine CurrentSince Dec 5, 2016 Accepting new patients
Hospital District No 6 of Harper County Kansas CurrentSince Apr 19, 2022 Accepting new patients
Mercy Kansas Communities Inc Past Accepting new patients
Emergency Services, PA Emergency Medicine Past Accepting new patients
Hospital District No 6 of Harper County Kansas Past Accepting new patients
Runway Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

221 W US Highway 54
Andover, KS 67002
Phone (316) 962-5100

485 N KS Hwy 2
Anthony, KS 67003
Phone (620) 914-1200

2648 N Rock Rd
Derby, KS 67037
Phone (316) 962-2000

8714 W 13th St N
Wichita, KS 67212
Phone (316) 962-9900

550 N Hillside St
Wichita, KS 67214
Phone (316) 688-2239

2610 N Woodlawn Blvd
Wichita, KS 67220
Phone (316) 684-3838

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164512315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 548",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672010548",
            "telephone_number": "316-962-2239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 N HILLSIDE ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672144910",
            "telephone_number": "316-962-2239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "KENT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KS",
            "license": "0425218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.