Individual provider Active NPI

Jeremy Ryan Potter, PT

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1346816022
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13409 Issued in TN
Practice address
1819 Clinch Ave Ste 106
Knoxville, TN 37916-2435
Phone
(865) 690-4861
NPI assigned
Jun 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 13409 TN Primary

Addresses

Primary practice location

1819 Clinch Ave Ste 106
Knoxville, TN 37916-2435

Mailing address

PO Box 306556
Nashville, TN 37230-6556
Phone (865) 243-8153

Other practice location 1

9430 Park West Blvd Ste 230
Knoxville, TN 37923-4204
Phone (865) 560-8550

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210609000862 TN Practitioner - Physical Therapist in Private Practice 6901206275 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prompt Physical Therapy Inc.Group PAC ID 4981675790, 5 clinicians

Practice addresses (Care Compare)

5822 Lyons View Pike
Suite B
Knoxville, TN 37919-6493
Phone (588) 865-6358

Merit-based Incentive Payment System (MIPS)

Final score
81.78 of 100Reported as group
Quality
65.3
Promoting interoperability
96
Improvement activities
40
Cost
77.31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prompt Physical Therapy Inc. Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Tennessee Orthopaedic Alliance PA CurrentSince Jun 2, 2021 Accepting new patients
Tennessee Orthopaedic Alliance PA CurrentSince Jun 2, 2021 Accepting new patients

Locations

5822 Lyons View Pike
Ste B
Knoxville, TN 37919
Phone (588) 865-6358

1819 Clinch Ave
Ste 100
Knoxville, TN 37916
Phone (865) 524-5305

9430 Park West Blvd
Ste 230
Knoxville, TN 37923
Phone (865) 560-8550

1819 Clinch Ave
Ste 106
Knoxville, TN 37916
Phone (865) 524-5365

8 City Blvd
Ste 100
Nashville, TN 37209
Phone (615) 263-0155

Interoperability endpoints

  • Direct secure messaging: jeremyr.potter.p2@direct.toa.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1346816022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306556",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306556",
            "telephone_number": "865-243-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 CLINCH AVE STE 106",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162435",
            "telephone_number": "865-690-4861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9430 Park West Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379234204",
            "country_code": "US",
            "telephone_number": "865-560-8550",
            "fax_number": "865-560-8551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTER",
        "first_name": "JEREMY",
        "middle_name": "RYAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "13409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.