Active NPI
Jeffrey Randall Potts, D.C.
- Rehabilitation Chiropractor
- San Jose, CA
National Provider Identifier
1356557920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Chiropractor
- License
- DC28278
- Practice address
- 5085 Adair Way
San Jose, CA 95124-5342 - Phone
- (408) 313-4442
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Rehabilitation Chiropractor | 111NR0400X | DC28278 | CA | Primary |
Addresses
Primary practice location
5085 Adair Way
San Jose, CA 95124-5342
Mailing address
5085 Adair Way
San Jose, CA 95124-5342
Phone (408) 313-4442
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040225001273 | CA | Practitioner - Chiropractic | 5991691966 | Practice locations: Campbell, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Cleveland Chiropractic College - Los Angeles, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2207 S Bascom Ave
Campbell, CA 95008-4351
Phone (408) 377-2207
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28278 | CA | MD | Clinical Social Worker |
| DC28278 | CA | MD | Rehabilitation Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283990400000",
"number": "1356557920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5085 ADAIR WAY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951245342",
"telephone_number": "408-313-4442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5085 ADAIR WAY",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951245342",
"telephone_number": "408-313-4442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTS",
"first_name": "JEFFREY",
"middle_name": "RANDALL",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2010-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "111NR0400X",
"taxonomy_group": "",
"desc": "Chiropractor, Rehabilitation",
"state": "CA",
"license": "DC28278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2010; 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.