Individual provider Active NPI

Samuel Potter, MD

  • Psychiatry Physician
  • Lexington, KY
National Provider Identifier
1306473889
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
59729 Issued in KY
Practice address
310 S Limestone
Lexington, KY 40508-3008
Phone
(859) 226-7063
Fax
(859) 226-7266
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 59729 KY Primary

Addresses

Primary practice location

310 S Limestone
Lexington, KY 40508-3008

Mailing address

245 Fountain Court
Lexington, KY 40509

Other practice location 1

245 Fountain Court
Lexington, KY 40509
Phone (859) 323-6021

Other practice location 2

1350 Bull Lea Rd
Lexington, KY 40511-1247
Phone (859) 246-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240912003303 KY Practitioner - Psychiatry 4880083013 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Kentucky College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kentucky Medical Services Foundation, IncGroup PAC ID 5698689909, 949 clinicians

Practice addresses (Care Compare)

310 S Limestone St
Lexington, KY 40508-3008
Phone (859) 226-7750

Hospital & facility affiliations

  • University of Kentucky Hospital Hospital, Lexington, KY, CCN 180067

Merit-based Incentive Payment System (MIPS)

Final score
85.77 of 100Reported as group
Quality
68.25
Promoting interoperability
100
Improvement activities
40
Cost
72.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
59729KYMDPsychiatry Physician
R5342KYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky Psychiatry CurrentSince Aug 27, 2024 Accepting new patients
Kentucky Medical Services Foundation, Inc Psychiatry CurrentSince Aug 27, 2024 Accepting new patients
University of Kentucky Past Accepting new patients
Commonwealth of Kentucky Past Accepting new patients

Locations

245 Fountain Ct
Lexington, KY 40509
Phone (859) 323-6021

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

1350 Bull Lea Rd
Lexington, KY 40511
Phone (859) 246-7363

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1306473889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 FOUNTAIN COURT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 S LIMESTONE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405083008",
            "telephone_number": "859-226-7063",
            "fax_number": "859-226-7266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Fountain Court",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "40509",
            "country_code": "US",
            "telephone_number": "859-323-6021",
            "fax_number": "859-323-4927",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1350 Bull Lea Rd",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405111247",
            "country_code": "US",
            "telephone_number": "859-246-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTER",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "59729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.