Active NPI
Ashley Marie Potter, PA-C
- Physician Assistant
- Haslet, TX
National Provider Identifier
1477707800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA11630
- Practice address
- 1205 Avondale Haslet Rd Ste 100
Haslet, TX 76052 - Phone
- (817) 766-4001
- Fax
- (817) 766-4008
- NPI assigned
- Nov 12, 2008
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA11630 | TX | Primary |
Addresses
Primary practice location
1205 Avondale Haslet Rd Ste 100
Haslet, TX 76052
Mailing address
6161 N Hwy 161
Credentialing Department
Irving, TX 75038-2220
Phone (972) 953-2439
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA11630 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541030400000",
"number": "1477707800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6161 N HWY 161",
"address_2": "CREDENTIALING DEPARTMENT",
"city": "IRVING",
"state": "TX",
"postal_code": "750382220",
"telephone_number": "972-953-2439",
"fax_number": "972-870-4915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1205 AVONDALE HASLET RD STE 100",
"city": "HASLET",
"state": "TX",
"postal_code": "76052",
"telephone_number": "817-766-4001",
"fax_number": "817-766-4008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "ASHLEY",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-12",
"last_updated": "2018-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA11630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Haslet, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.