Active NPI
Jayden A Potter
- Case Manager/Care Coordinator
- Poteau, OK
National Provider Identifier
1346823424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 804 S Broadway St
Poteau, OK 74953-3834 - Phone
- (918) 647-9629
- NPI assigned
- May 5, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
804 S Broadway St
Poteau, OK 74953-3834
Mailing address
804 S Broadway St
Poteau, OK 74953-3834
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| YUQ947032551 | Other | OK | BLUECROSS BLUESHIELD |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Psychological Development, Inc. | Current | Accepting new patients |
Locations
804 S Broadway St
Poteau, OK 74953
Phone (918) 647-9269
Organizations & group practices 1
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.
-
- Mental Health Counselor
- Durant, OK
- NPI 1831409440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1346823424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 S BROADWAY ST",
"city": "POTEAU",
"state": "OK",
"postal_code": "749533834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 S BROADWAY ST",
"city": "POTEAU",
"state": "OK",
"postal_code": "749533834",
"telephone_number": "918-647-9629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "JAYDEN",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-05",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "YUQ947032551",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poteau, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 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.