NPIMap

Individual provider Active NPI

Steven Jared Potter, MD

  • Family Medicine Physician
  • Rigby, ID
National Provider Identifier
1407922446
Registry record updated Apr 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M-19057 Issued in ID
Practice address
480 Rigby Lake Drive
Rigby, ID 83442
Phone
(208) 745-3500
Fax
(208) 745-3501
NPI assigned
Nov 28, 2006
Last updated
Apr 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 57481181205 UT
Family Medicine Physician 207Q00000X M-19057 ID Primary

Addresses

Primary practice location

480 Rigby Lake Drive
Rigby, ID 83442

Mailing address

480 Rigby Lake Drive
Rigby, ID 83442
Phone (801) 230-5182

Other identifiers 1

IdentifierTypeStateIssuer
57481181205OtherUTLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070129000072 UT Practitioner - Family Practice 9830190222 Reassigns benefits to 1 organization
I20200601001559 ID Practitioner - Family Practice 9830190222 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Maryland School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

480 Rigby Lake Dr
Rigby, ID 83442-5280
Phone (208) 745-3500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-19057IDMDFamily Medicine Physician
57481181205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Group of Utah Inc CurrentSince Oct 1, 2013 Accepting new patients
Rigby Family Medicine LLC Family Medicine CurrentSince May 1, 2020 Accepting new patients

Locations

480 Rigby Lake Dr
Rigby, ID 83442
Phone (208) 745-3500

124 S Fairfield Rd
Layton, UT 84041
Phone (801) 546-9441

1600 W Antelope Dr
Layton, UT 84041
Phone (801) 807-1000

2530 W 4700 S
Ste B8
Taylorsville, UT 84129
Phone (801) 967-5866

3580 W 90th S
West Jordan, UT 84088
Phone (801) 263-0810

Interoperability endpoints

  • Direct secure messaging: rigbyfamilymedicine.jaredpotter@145837.advancedmd-direct.com

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587686400000",
    "number": "1407922446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 RIGBY LAKE DRIVE",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "83442",
            "telephone_number": "801-230-5182",
            "fax_number": "208-745-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 RIGBY LAKE DRIVE",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "83442",
            "telephone_number": "208-745-3500",
            "fax_number": "208-745-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "STEVEN",
        "middle_name": "JARED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-04-24",
        "certification_date": "2020-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "57481181205",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M-19057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "57481181205",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rigby, ID

Sources for this page

Verify at the official NPI Registry.