Jack Potts X, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

12185 Issued in AZ

Practice address

221 E Indianola Ave
Phoenix, AZ 85012-2002

Phone

(602) 274-5494

Fax

(602) 264-5566

NPI assigned

Aug 25, 2006

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1245348812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E INDIANOLA AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122002",
            "telephone_number": "602-274-5494",
            "fax_number": "602-264-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E INDIANOLA AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122002",
            "telephone_number": "602-274-5494",
            "fax_number": "602-264-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "name_suffix": "X",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-25",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "AZ",
            "license": "AZ12185",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "12185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Potters Place, LLC
• Tamara I Pottker, M.D.
• Jeremy Pottle, LMSW
• Celeste E Pottorff, D.O.
• Donald M Potts, MD
• James Potts
• Amanda Potucek, NP
• Jessica M Potvin, PHD
• Mark J Poulin, NP
• Andrew Poulos, MD

• Psychiatry Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.