Frederick Woodbridge Potter, MA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

4612 N 56TH St
Tampa, FL 33610-7123

Phone

(813) 753-9246

Fax

(866) 760-6190

NPI assigned

Feb 26, 2007

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Thriveworks Clinical - Florida IncGroup PAC ID 5496173577, 85 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Thriveworks Clinical - Florida Inc

  • Mental Health Counselor
  • Fort Lauderdale, FL
  • NPI 1396360996
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1174659726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4612 N 56TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336107123",
            "telephone_number": "813-753-9246",
            "fax_number": "866-760-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 N 56TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336107123",
            "telephone_number": "813-753-9246",
            "fax_number": "866-760-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "FREDERICK",
        "middle_name": "WOODBRIDGE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "None",
            "affiliation": "N",
            "endpointDescription": "None",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "None",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "None",
            "address_1": "4612 N 56th St",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336107123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anita Pothen, PHARMD
• Salma Z Pothiawala, MD
• Yakub Ahmed Pothiawala, MD
• Victoria Marie Potocki, LMHC
• Sangy Paul Pottackal, M.D.
• Matthew Potter, PHARMD
• Lisa M Potthast, PA
• Elizabeth Ann Potts, LCSW
• Kacey Garcia Poulin, MA,CCC-SLP
• Eric Pourmand, M.D.

• Clinical Social Worker in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.