NPIMap

Individual provider Active NPI

Samuel Ernest Potts, D.P.M.

  • Podiatrist
  • Greer, SC
National Provider Identifier
1326058447
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
766 Issued in SC
Practice address
340 Medical Pkwy Ste 250
Greer, SC 29650-2441
Phone
(864) 797-9480
Fax
(864) 797-9482
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 016004684 IL
Radiology Podiatrist 213ER0200X 016004684 IL
Foot Surgery Podiatrist 213ES0131X 016004684 IL
Podiatrist 213E00000X 766 SC Primary

Addresses

Primary practice location

340 Medical Pkwy Ste 250
Greer, SC 29650-2441

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 695-6697

Other practice location 1

2 Memorial Dr
Suite 201
Decatur, IL 62526-3950
Phone (217) 875-6980

Other identifiers 3

IdentifierTypeStateIssuer
5805819OtherILBLUE CROSS BLUE SHIELD
230121OtherHEALTHLINK
480014432OtherPALMETTA GBA-RR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240429002248 SC Practitioner - Podiatry 3173591484 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 Fleetwood Dr
Easley, SC 29640-2022
Phone (864) 442-7618

200 Patewood Dr
Suite C300
Greenville, SC 29615-6324
Phone (864) 454-8272

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

298 Memorial Dr
Seneca, SC 29672-9443
Phone (864) 455-2455

300 E McBee Ave
Greenville, SC 29601-2842
Phone (864) 797-6220

300 E McBee Ave FL
Suite 4
Greenville, SC 29601-2842

340 Medical Pkwy
Greer, SC 29650-2441

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.33 of 100Reported as group
Quality
75.48
Promoting interoperability
100
Improvement activities
40
Cost
72.29

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue325
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
766SCMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince May 6, 2024 Accepting new patients
Prisma Health University Medical Group CurrentSince May 6, 2024 Accepting new patients

Locations

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

340 Medical Pkwy
Ste 250
Greer, SC 29650
Phone (864) 797-9480

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

Interoperability endpoints

  • Direct secure messaging: spotts762586@direct.ghs.myhfn.org

Organizations & group practices 2

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 59

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

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1326058447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-695-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MEDICAL PKWY STE 250",
            "city": "GREER",
            "state": "SC",
            "postal_code": "296502441",
            "telephone_number": "864-797-9480",
            "fax_number": "864-797-9482"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Memorial Dr",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625263950",
            "country_code": "US",
            "telephone_number": "217-875-6980",
            "fax_number": "217-875-7710",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTS",
        "first_name": "SAMUEL",
        "middle_name": "ERNEST",
        "name_prefix": "Mr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016004684",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "IL",
            "license": "016004684",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IL",
            "license": "016004684",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5805819",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "230121",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTA GBA-RR MEDICARE",
            "identifier": "480014432",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greer, SC

Sources for this page

Verify at the official NPI Registry.