Individual provider Active NPI

Samantha Ariel Pottorf, CRNP

  • Acute Care Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1336819549
Registry record updated Sep 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-168543 Issued in AL
Practice address
930 Franklin St SE
Huntsville, AL 35801-4312
Phone
(256) 533-3388
NPI assigned
Sep 18, 2021
Last updated
Sep 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-168543 AL Primary

Addresses

Primary practice location

930 Franklin St SE
Huntsville, AL 35801-4312

Mailing address

4601 Pheasant Cove Dr SE
Owens Cross Roads, AL 35763-3017
Phone (309) 738-9990

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL huntsville

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

State licenses

LicenseStateTypeSpecialty
1-168543ALMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1631923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631923200000",
    "number": "1336819549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PHEASANT COVE DR SE",
            "city": "OWENS CROSS ROADS",
            "state": "AL",
            "postal_code": "357633017",
            "telephone_number": "309-738-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 FRANKLIN ST SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014312",
            "telephone_number": "256-533-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTORF",
        "first_name": "SAMANTHA",
        "middle_name": "ARIEL",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-18",
        "last_updated": "2021-09-18",
        "certification_date": "2021-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-168543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "huntsville",
            "affiliation": "N",
            "address_1": "930 Franklin St SE",
            "city": "Huntsville",
            "state": "AL",
            "country_code": "US",
            "postal_code": "358014312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2021; 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.