Individual provider Active NPI

Shaun Stuart Potier, DPT

  • Physical Therapist
  • Mountain Home, AR
National Provider Identifier
1255007407
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5002 Issued in AR
Practice address
3 Medical PLZ
Mountain Home, AR 72653-2918
Phone
(870) 424-3400
Fax
(870) 424-4121
NPI assigned
Aug 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5002 AR Primary

Addresses

Primary practice location

3 Medical PLZ
Mountain Home, AR 72653-2918

Mailing address

3 Medical PLZ
Mountain Home, AR 72653-2918
Phone (870) 424-3400

Other names 1

  • Shaun Stuart Potgieter Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210825002538 AR Practitioner - Physical Therapist in Private Practice 6608271820 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Orthopaedic Health CareGroup PAC ID 1052446051, 5 clinicians

Practice addresses (Care Compare)

3 Medical PLZ
Mountain Home, AR 72653-2918
Phone 8704243400306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT5002ARMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Barnhill Therapy Services, LLC Physical Therapist CurrentSince Jul 8, 2023 Accepting new patients
Regional Orthopaedic Health Care CurrentSince Aug 18, 2021 Accepting new patients
North Arkansas Speech Services, LLC Physical Therapist CurrentSince Sep 26, 2022 Accepting new patients

Locations

75 Highway 62 412
Ste J
Ash Flat, AR 72513
Phone (870) 206-9430

3 Medical Plz
Mountain Home, AR 72653
Phone (870) 424-3181

400 S College St
Ste 3
Mountain Home, AR 72653
Phone (870) 404-0270

120 Highway 201 N
Mountain Home, AR 72653
Phone (870) 421-1924

Organizations & group practices 3

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": "1629244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1255007407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MEDICAL PLZ",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532918",
            "telephone_number": "870-424-3400",
            "fax_number": "870-424-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MEDICAL PLZ",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726532918",
            "telephone_number": "870-424-3400",
            "fax_number": "870-424-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTIER",
        "first_name": "SHAUN",
        "middle_name": "STUART",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-18",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT5002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAUN",
            "last_name": "POTGIETER",
            "middle_name": "STUART",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.