Individual provider Active NPI

Jeffrey Daniel Potts, DPT

  • Physical Therapist
  • Birmingham, AL
National Provider Identifier
1174878243
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH8369 Issued in AL
Practice address
5285 Highway 280
Suite 109
Birmingham, AL 35242-0316
Phone
(205) 607-0903
Fax
(205) 607-0904
NPI assigned
Jul 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9399 TN
Physical Therapist 225100000X 1273500 TX
Physical Therapist 225100000X PTH8369 AL Primary

Addresses

Primary practice location

5285 Highway 280
Suite 109
Birmingham, AL 35242-0316

Mailing address

800 Crescent Centre Dr
Suite 600
Franklin, TN 37067-7269
Phone (615) 373-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120808000585 TN Practitioner - Physical Therapist in Private Practice 2567618440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Rehabilitation and SportsGroup PAC ID 1759481559, 53 clinicians

Practice addresses (Care Compare)

313 Manufacturers Rd
Suite C215
Chattanooga, TN 37405-3274
Phone (423) 254-5461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1273500TXMDPhysical Therapist
9399TNMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Rehabilitation and Sports Physical Therapist CurrentSince Apr 12, 2018 Accepting new patients
Excel Rehabilitation and Sports Physical Therapist CurrentSince Apr 12, 2018 Accepting new patients

Locations

501 Forest Ln
Ste A
Clemson, SC 29631
Phone (864) 654-2001

2158 Northgate Park Ln
Ste 200
Chattanooga, TN 37415
Phone (423) 254-5461

313 Manufacturers Rd
Ste C215
Chattanooga, TN 37405
Phone (423) 254-5461

7443 Commons Blvd
Ste 112
Chattanooga, TN 37421
Phone (423) 254-5461

1700 Broad St
Ste 120
Chattanooga, TN 37408
Phone (423) 254-5461

862 Callen Ln NW
Ste 100
Cleveland, TN 37312
Phone (423) 254-5461

Organizations & group practices 2

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": "1342396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1174878243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 CRESCENT CENTRE DR",
            "address_2": "SUITE 600",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370677269",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5285 HIGHWAY 280",
            "address_2": "SUITE 109",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352420316",
            "telephone_number": "205-607-0903",
            "fax_number": "205-607-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "JEFFREY",
        "middle_name": "DANIEL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-16",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "9399",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1273500",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH8369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.