Active NPI
Michael L. Potter, M.D.
- Sports Medicine (Family Medicine) Physician
- Medford, OR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- MD23161
- Practice address
- 70 Bower Dr Ste 240
Medford, OR 97501-3689 - Phone
- (541) 732-8790
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | MD23161 | OR | Primary |
| Family Medicine Physician | 207Q00000X | MD23161 | OR |
Addresses
Primary practice location
70 Bower Dr Ste 240
Medford, OR 97501-3689
Mailing address
PO Box 3158
Portland, OR 97208-3158
Phone (503) 215-6494
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 228818 | Medicaid | OR |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mpotter855467@oc.providencedirect.org | ||
| Direct Messaging Address | mpotter855467@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Sports Medicine
- Education
- Oregon Health Sciences University School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
870 S Front St
Suite 200
Central Point, OR 97502-2779
Phone (541) 664-3346
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD23161 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services Oregon | Family Medicine | Current | Accepting new patients |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Providence Health & Services - Oregon | Family Medicine | Current | Accepting new patients |
| Providence Health & Services - Oregon | Current | Accepting new patients | |
| Firstcare Medical Foundation | Family Medicine | Past | Accepting new patients |
Locations
940 Royal Ave
Unit 350
Medford, OR 97504
Phone (541) 732-7460
965 Ellendale Dr
Medford, OR 97504
Phone (541) 732-6000
70 Bower Dr
Ste 240
Medford, OR 97501
Phone (541) 732-8360
1111 Crater Lake Ave
Medford, OR 97504
Phone (541) 732-5250
870 S Front St
Ste 200
Medford, OR 97502
Phone (541) 664-3346
Interoperability endpoints
- mpotter855467@oc.providencedirect.org
Organizations & group practices 6
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.
-
- Family Medicine Physician
- Medford, OR
- NPI 1568547503
-
- Clinic/Center
- Medford, OR
- NPI 1093976243
-
- Clinical Pathology Physician
- Medford, OR
- NPI 1285185942
Family Medicine
-
- Internal Medicine Physician
- Central Point, OR
- NPI 1609951649
-
- Clinic/Center
- Phoenix, OR
- NPI 1992882500
-
- Family Medicine Physician
- Albany, OR
- NPI 1740216498
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Medford, OR
- NPI 1770587107
-
- General Acute Care Hospital
- Medford, OR
- NPI 1689755670
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1457388191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3158",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083158",
"telephone_number": "503-215-6494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 BOWER DR STE 240",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975013689",
"telephone_number": "541-732-8790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "MICHAEL",
"middle_name": "L.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-27",
"last_updated": "2023-11-29",
"certification_date": "2023-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "OR",
"license": "MD23161",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD23161",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "228818",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mpotter855467@oc.providencedirect.org",
"affiliation": "N",
"address_1": "70 Bower Dr Ste 240",
"city": "Medford",
"state": "OR",
"country_code": "US",
"postal_code": "975013689",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mpotter855467@oc.providencedirect.org",
"affiliation": "N",
"address_1": "70 S FRONT ST",
"address_2": "suite 200",
"city": "central point",
"state": "OR",
"country_code": "US",
"postal_code": "97502",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.