Organization Active NPI

Dogwood Wellness, PA

  • General Practice Physician
  • Sylva, NC
National Provider Identifier
1235398165
Registry record updated Apr 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
DOGWOOD WELLNESS, PA
Practice address
377 Macktown Rd
Sylva, NC 28779-7627
Phone
(828) 586-6262
Fax
(828) 412-4294
NPI assigned
Jun 5, 2008
Last updated
Apr 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2022

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

Authorized official

Name
Dr. Graeme Maria Potter, MDNPI 1770526691
Title
Owner
Phone
(828) 586-6262

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

377 Macktown Rd
Sylva, NC 28779-7627

Mailing address

PO Box 1125
Dillsboro, NC 28725-1125
Phone (828) 586-6262

Other identifiers 2

IdentifierTypeStateIssuer
5907766MedicaidNC
7274023OtherCIGNA

Other names 1

  • Backacre Medical, PLLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080923000484 NC Part B Supplier - Clinic/Group Practice 5496822033 Receives reassigned benefits from 2 practitioners
Practice locations: Sylva, NC

National Provider Directory

National Provider Directory

Locations

114 W Hemlock St
Sylva, NC 28779
Phone (828) 586-6262

377 Macktown Rd
Sylva, NC 28779
Phone (828) 586-6262

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650672000000",
    "number": "1235398165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1125",
            "city": "DILLSBORO",
            "state": "NC",
            "postal_code": "287251125",
            "telephone_number": "828-586-6262",
            "fax_number": "828-586-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "377 MACKTOWN RD",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287797627",
            "telephone_number": "828-586-6262",
            "fax_number": "828-412-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOGWOOD WELLNESS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-23",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "GRAEME",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-586-6262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5907766",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7274023",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Backacre Medical, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Backacre Medical, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Sylva, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.