Clinton J Potter MD PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME 103986 Issued in FL

Legal business name

CLINTON J POTTER MD PA

Doing business as

Advanced Individualized Medicine of Naples

Practice address

720 Goodlette Rd N
Ste. 204
Naples, FL 34102-5656

Phone

(239) 260-3880

Fax

(239) 260-3881

NPI assigned

Feb 2, 2017

Last updated

Feb 2, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Clinton J. Potter, M.D.

Title

President/Secretary

Phone

(415) 377-7905

Specialties & licenses 1

Addresses

Other names 1

• Advanced Individualized Medicine of Naples Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485993600000",
    "number": "1407394109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 SEASONS WAY UNIT 901",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "339282375",
            "telephone_number": "415-377-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 GOODLETTE RD N",
            "address_2": "STE. 204",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025656",
            "telephone_number": "239-260-3880",
            "fax_number": "239-260-3881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON J POTTER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT/SECRETARY",
        "authorized_official_telephone_number": "415-377-7905",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME 103986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Individualized Medicine of Naples",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Naples, FL
• Providers in Naples, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.