Individual provider Active NPI

Brittany Hall-Potvin, PA-C

  • Physician Assistant
  • New London, CT
National Provider Identifier
1407317118
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
365 Montauk Ave
New London, CT 06320-4700
Phone
(860) 442-0711
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

365 Montauk Ave
New London, CT 06320-4700

Mailing address

365 Montauk Ave
New London, CT 06320-4769
Phone (860) 442-0711

Other practice location 1

52 Hazelnut Hill Rd
Groton, CT 06340-3268
Phone (860) 446-8265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, CT, MI3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190618000041 NC Practitioner - Physician Assistant 4880927227 Reassigns benefits to 2 organizations
I20231214002822 CT Practitioner - Physician Assistant 4880927227 Reassigns benefits to 1 organization
I20240723002360 MI Practitioner - Physician Assistant 4880927227 Reassigns benefits to 20 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Troy Urgent Care Walk in ClinicGroup PAC ID 5799039061, 4 clinicians

Practice addresses (Care Compare)

4060 Rochester Rd
Troy, MI 48085-4923
Phone (248) 250-6420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5512CTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence and Memorial Hospital, Inc. CurrentSince Dec 1, 2023 Accepting new patients
Alamance Regional Medical Center, Inc CurrentSince May 11, 2020 Accepting new patients
The Moses H. Cone Memorial Hospital Operating Corporation Physician Assistant CurrentSince May 11, 2020 Accepting new patients
Lawrence and Memorial Hospital, Inc. Physician Assistant CurrentSince Dec 1, 2023 Accepting new patients
Rochester Urgent Care, P. C. CurrentSince Oct 1, 2024 Accepting new patients
Lakeside Urgent Care, P.C. CurrentSince Oct 1, 2024 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince May 11, 2020 Accepting new patients
First Choice Urgent Care PC Past Accepting new patients
Telegraph Urgent Care PLLC Past Accepting new patients
Oxford Urgent Care, LLC Past Accepting new patients
Doctors Urgent Care Southfield Past Accepting new patients

Locations

52 Hazelnut Hill Rd
Groton, CT 06340
Phone (860) 446-8265

365 Montauk Ave
New London, CT 06320
Phone (860) 271-4364

44472 Hayes Rd
Clinton Twp, MI 48038
Phone (586) 412-0890

2952 S Rochester Rd
Rochester Hills, MI 48307
Phone (248) 853-2009

215 E Auburn Rd
Rochester Hills, MI 48307
Phone (248) 853-2009

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

1131 N Church St
Greensboro, NC 27401
Phone (336) 358-5100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

2400 W Friendly Ave
Greensboro, NC 27403
Phone (336) 832-1100

618 S Main St
Reidsville, NC 27320
Phone (336) 832-7965

Organizations & group practices 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1407317118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204769",
            "telephone_number": "860-442-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204700",
            "telephone_number": "860-442-0711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 Hazelnut Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Groton",
            "state": "CT",
            "postal_code": "063403268",
            "country_code": "US",
            "telephone_number": "860-446-8265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL-POTVIN",
        "first_name": "BRITTANY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

Verify at the official NPI Registry.