Lowell Kenneth Pottenger, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

30716 Issued in MO

Practice address

4400 Eden Hall LN
Joplin, MO 64803

Phone

(417) 781-4090

Fax

(414) 782-1601

NPI assigned

Jun 6, 2007

Last updated

Dec 7, 2012By 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 1

Addresses

Other identifiers 2

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354838400000",
    "number": "1316140650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2486",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648032486",
            "telephone_number": "417-781-4090",
            "fax_number": "414-782-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 EDEN HALL LN",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64803",
            "telephone_number": "417-781-4090",
            "fax_number": "414-782-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTENGER",
        "first_name": "LOWELL",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-06",
        "last_updated": "2012-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "30716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200600807",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04936673136",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neal R. Popichak, CRNA
• Karen Lynn Porte, MD.
• Matthew Porte, APSW
• Ashlyn N Porter
• Tanner Steven Poss
• Adam D Potter, CNP
• Kandi Monique Potter, P.T.
• Avril Prabakaran, RPT
• Carolyn Pearl Prater, D.O.
• Preferred Family Healthcare

• Diagnostic Radiology Physician in Joplin, MO
• Providers in Joplin, MO by specialty
• Diagnostic Radiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; 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.