Active NPI
Donald Potter
- Professional Counselor
- Berea, OH
National Provider Identifier
1396094181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- S1100448
- Practice address
- 202 E Bagley Rd
Berea, OH 44017-2058 - Phone
- (800) 234-2006
- NPI assigned
- Sep 7, 2012
- Last updated
- Sep 7, 2012
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | S1100448 | OH | Primary |
Addresses
Primary practice location
202 E Bagley Rd
Berea, OH 44017-2058
Mailing address
202 E Bagley Rd
Berea, OH 44017-2058
Phone (800) 234-2006
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
819 McKay CT
Suite 102
Boardman, OH 44512-5771
Phone (330) 259-4849
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S1100448 | OH | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Watson Community Health Centre | Current | Accepting new patients |
Locations
16603 Harvard Ave
Cleveland, OH 44128
Phone (216) 921-5222
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Addiction Medicine (Psychiatry & Neurology) Physician
- Boardman, OH
- NPI 1356612261
-
- Community Health Clinic/Center
- Cleveland, OH
- NPI 1326761578
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346976000000",
"number": "1396094181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 E BAGLEY RD",
"city": "BEREA",
"state": "OH",
"postal_code": "440172058",
"telephone_number": "800-234-2006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 E BAGLEY RD",
"city": "BEREA",
"state": "OH",
"postal_code": "440172058",
"telephone_number": "800-234-2006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "DONALD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-07",
"last_updated": "2012-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "S1100448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berea, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.