Active NPI
Katherine Marie Potter, O.D.
- Optometrist
- Jackson, MI
National Provider Identifier
1457582983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901004526
- Practice address
- 3600 Oneil Dr
Jackson, MI 49202-1857 - Phone
- (517) 788-6104
- Fax
- (517) 788-6106
- NPI assigned
- Jul 31, 2009
- Last updated
- Oct 14, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4901004526 | MI | Primary |
Addresses
Primary practice location
3600 Oneil Dr
Jackson, MI 49202-1857
Mailing address
1122 Arms St
Apartment 14
Marshall, MI 49068-2123
Phone (517) 980-0837
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901004526 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pasqua Darnell PC | Optometrist | Past | Accepting new patients |
| Melissa M David OD PLLC | Optometrist | Past | Accepting new patients |
| Dietrich PC | Optometrist | Past | Accepting new patients |
| Pasqua LLC | Optometrist | Past | Accepting new patients |
Organizations & group practices 4
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287014400000",
"number": "1457582983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1122 ARMS ST",
"address_2": "APARTMENT 14",
"city": "MARSHALL",
"state": "MI",
"postal_code": "490682123",
"telephone_number": "517-980-0837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 ONEIL DR",
"city": "JACKSON",
"state": "MI",
"postal_code": "492021857",
"telephone_number": "517-788-6104",
"fax_number": "517-788-6106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "KATHERINE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-31",
"last_updated": "2010-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901004526",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.