Active NPI
David Thomas Potter, MD
- Psychiatry Physician
- Spokane, WA
National Provider Identifier
1396759197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD00046532
- Practice address
- 107 S Division St
Spokane, WA 99202 - Phone
- (509) 838-4651
- Fax
- (509) 363-2762
- NPI assigned
- Jul 28, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | D0060488 | MD | |
| Pain Medicine (Psychiatry & Neurology) Physician | 2084P2900X | MD00046532 | WA | |
| Psychiatry Physician | 2084P0800X | MD00046532 | WA | Primary |
Addresses
Primary practice location
107 S Division St
Spokane, WA 99202
Mailing address
107 S Division St
Spokane, WA 99202-1510
Phone (509) 838-4651
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 402429000 | Medicaid | MD | |
| 1396759197 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- University of Maryland School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
107 S Division St
Spokane, WA 99202-1510
Phone (509) 838-4651
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0060488 | MD | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frontier Behavioral Health | Psychiatry | Current | Accepting new patients |
| University of Maryland Psychiatry Associates, PA | Psychiatry | Past | Accepting new patients |
Locations
107 S Division St
Spokane, WA 99202
Phone (509) 383-4651
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 and National Provider Directory roles.
-
dba Psychiatry Associates, PA
- Psychiatry Physician
- Baltimore, MD
- NPI 1649292699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526428800000",
"number": "1396759197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 S DIVISION ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992021510",
"telephone_number": "509-838-4651",
"fax_number": "509-363-2762"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 S DIVISION ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99202",
"telephone_number": "509-838-4651",
"fax_number": "509-363-2762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "DAVID",
"middle_name": "THOMAS",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2018-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MD",
"license": "D0060488",
"primary": false
},
{
"code": "2084P2900X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Pain Medicine",
"state": "WA",
"license": "MD00046532",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "MD00046532",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "402429000",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1396759197",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; 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.