Individual provider Active NPI

Michelle Tracy Potter, RN, BSN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Tulsa, OK
National Provider Identifier
1427718337
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
L-306045 Issued in VA
Practice address
6161 S Yale Ave
Tulsa, OK 74136-1992
Phone
(918) 494-6455
NPI assigned
Dec 20, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R0126433 OK
Lactation Consultant (Registered Nurse) 163WL0100X L-306045 VA Primary

Addresses

Primary practice location

6161 S Yale Ave
Tulsa, OK 74136-1992

Mailing address

7617 S Quebec PL
Tulsa, OK 74136-8108
Phone (303) 919-6293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R0126433OKMDRegistered Nurse
L-306045VAMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1427718337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7617 S QUEBEC PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741368108",
            "telephone_number": "303-919-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6161 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741361992",
            "telephone_number": "918-494-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "MICHELLE",
        "middle_name": "TRACY",
        "name_prefix": "Mrs.",
        "credential": "RN,  BSN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0126433",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "VA",
            "license": "L-306045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.