Active NPI
Brian S. Potter, PSYD
- Clinical Neuropsychologist
- Memphis, TN
National Provider Identifier
1174775811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 3108
- Practice address
- 1211 Union Ave
Suite 700
Memphis, TN 38104-6638 - Phone
- (901) 287-5182
- Fax
- (901) 287-6700
- NPI assigned
- Oct 14, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 3108 | TN | Primary |
Addresses
Primary practice location
1211 Union Ave
Suite 700
Memphis, TN 38104-6638
Mailing address
1211 Union Ave
Suite 700
Memphis, TN 38104-6638
Phone (901) 287-5182
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3108 | TN | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353888000000",
"number": "1174775811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211 UNION AVE",
"address_2": "SUITE 700",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381046638",
"telephone_number": "901-287-5182",
"fax_number": "901-287-6700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211 UNION AVE",
"address_2": "SUITE 700",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381046638",
"telephone_number": "901-287-5182",
"fax_number": "901-287-6700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "BRIAN",
"middle_name": "S.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-14",
"last_updated": "2012-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "TN",
"license": "3108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.