Active NPI
Sue A Potter
- Pharmacist
- Boerne, TX
National Provider Identifier
1194310375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28222
- Practice address
- 27228 Boerne GLN
Boerne, TX 78006-5227 - Phone
- (210) 393-5757
- NPI assigned
- Mar 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28222 | TX | Primary |
Addresses
Primary practice location
27228 Boerne GLN
Boerne, TX 78006-5227
Mailing address
27228 Boerne GLN
Boerne, TX 78006-5227
Phone (210) 393-5757
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28222 | Other | TX | TEXAS STATE BOARD OF PHARMACY |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28222 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615248000000",
"number": "1194310375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27228 BOERNE GLN",
"city": "BOERNE",
"state": "TX",
"postal_code": "780065227",
"telephone_number": "210-393-5757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27228 BOERNE GLN",
"city": "BOERNE",
"state": "TX",
"postal_code": "780065227",
"telephone_number": "210-393-5757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "SUE",
"middle_name": "A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-09",
"last_updated": "2021-03-09",
"certification_date": "2021-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "28222",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS STATE BOARD OF PHARMACY",
"identifier": "28222",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boerne, TX
- Olivia Polk, RBT
- Grace Pomager, RN
- Gerardo Ponce
- Mitchell W Ponsford, DMD
- Autumn Postell, PA
- Kiley M Pradon, DPT
- Premier Boerne Dental, PLLC (Premier Dental Boerne)
- Premier Physical Therapy & Wellness, LLC
- Premium Pharma, LLC (The Pharmacy at Bergheim)
- Preslar Senior Care LLC (Home Instead Franchise 577)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.