NPIMap

Organization Active NPI

Edger V Potter Jr MD Inc

  • Internal Medicine Physician
  • Fort Washington, MD
National Provider Identifier
1376735100
Registry record updated Sep 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD9565 Issued in DC
Legal business name
EDGER V POTTER JR MD INC
Practice address
12017 Fort Washington Rd
Fort Washington, MD 20744-6004
Phone
(301) 203-9570
Fax
(301) 203-1796
NPI assigned
Aug 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2011

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

Authorized official

Name
Dr. Edger Verdan Potter Jr., MD
Title
President
Phone
(301) 203-9570

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207QG0300X MD9565 DC
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X MD9565 DC Primary
Rheumatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RR0500X MD9565 DC

Addresses

Primary practice location

12017 Fort Washington Rd
Fort Washington, MD 20744-6004

Mailing address

12017 Fort Washington Rd
Fort Washington, MD 20744-6004
Phone (301) 203-9570

Other identifiers 2

IdentifierTypeStateIssuer
023634400MedicaidDC
260891000MedicaidMD

National Provider Directory

National Provider Directory

Locations

1328 Southern Ave SE
Ste 210
Washington, DC 20032
Phone (202) 574-0540

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316131200000",
    "number": "1376735100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12017 FORT WASHINGTON RD",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207446004",
            "telephone_number": "301-203-9570",
            "fax_number": "301-203-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12017 FORT WASHINGTON RD",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207446004",
            "telephone_number": "301-203-9570",
            "fax_number": "301-203-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGER V POTTER JR MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2011-09-16",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "EDGER",
        "authorized_official_middle_name": "VERDAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-203-9570",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "DC",
            "license": "MD9565",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD9565",
            "primary": true
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "DC",
            "license": "MD9565",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023634400",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260891000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Washington, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2011; 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.