Michael Potter

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8472 Issued in ID

Practice address

1460 Elk Creek Dr
Idaho Falls, ID 83404-8237

Phone

(208) 535-1286

NPI assigned

Aug 31, 2023

Last updated

Aug 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Performance Therapy, LLCGroup PAC ID 8426189648, 3 clinicians

Mountain Land Rehabilitation LLCGroup PAC ID 9234048745, 207 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Performance Therapy, LLC

  • Physical Therapist
  • Idaho Falls, ID
  • NPI 1427375724
  Medicare reassignment Care Compare group NPD
• Mountain Land Rehabilitation LLC

  • Physical Therapist
  • Salt Lake City, UT
  • NPI 1265549372
  Care Compare group
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  NPD (past)
• Speech and Language Clinic, Inc

  • Speech-Language Pathologist
  • Ammon, ID
  • NPI 1891953519
  NPD (past)

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1427834969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 ELK CREEK DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048237",
            "telephone_number": "208-535-1286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-31",
        "last_updated": "2024-08-01",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "ID",
            "license": "8472",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "8472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa L. Porter, O.D.
• Misty Porter
• Jason Michael Poston, MD
• Brynn Noel Potere
• Aaron Ryan Potter, PA-C
• Alan Jake Poulter, MD
• Preston Roger Poulter, OTR/L MSOT
• Brecon Powell, PHARMD
• Carly Kay Powell
• Tara Powell, PA-C

• Physical Therapist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.