Kathryn Potter

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201004954 Issued in MI

Practice address

917 Beville Rd
Ste G
South Daytona, FL 32119-1712

Phone

(800) 330-7711

Fax

(866) 426-2811

NPI assigned

Jun 11, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1376770792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 MORTON AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494411424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 BEVILLE RD",
            "address_2": "STE G",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191712",
            "telephone_number": "800-330-7711",
            "fax_number": "866-426-2811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "851 Penniman Ave",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MI",
            "postal_code": "481701621",
            "country_code": "US",
            "telephone_number": "248-349-9595",
            "fax_number": "989-509-5965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTER",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-11",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201004954",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Phillips
• Adriana Correa Porter, DMD
• Jennifer Gessler Porter, DPT, PT
• Karen Sue Porter, M.ED., LGPC
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• Kathleen Premock
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• Stacy Hudock Proscia, DC
• Publix Super Markets Inc
• Karen Sue Pulaski, P.T.

• Occupational Therapist in South Daytona, FL
• Providers in South Daytona, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.