Individual provider Active NPI

Kevin L Potts, RPH

  • Pharmacist
  • Irmo, SC
National Provider Identifier
1265712707
Registry record updated Aug 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
7519 Issued in SC
Practice address
1345B Lake Murray Blvd
Irmo, SC 29063-2839
Phone
(803) 749-5924
Fax
(803) 749-3763
NPI assigned
Aug 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 7519 SC Primary

Addresses

Primary practice location

1345B Lake Murray Blvd
Irmo, SC 29063-2839

Mailing address

1345B Lake Murray Blvd
Irmo, SC 29063-2839
Phone (803) 749-5924

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
7519SCMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1314403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314403200000",
    "number": "1265712707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345B LAKE MURRAY BLVD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632839",
            "telephone_number": "803-749-5924",
            "fax_number": "803-749-3763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345B LAKE MURRAY BLVD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632839",
            "telephone_number": "803-749-5924",
            "fax_number": "803-749-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "KEVIN",
        "middle_name": "L",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-27",
        "last_updated": "2011-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "SC",
            "license": "7519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irmo, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2011; 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.