Shawn Jessica Potak

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

Practice address

105 Spindle Rd
Hicksville, NY 11801-6248

Phone

(516) 647-1813

NPI assigned

Jul 22, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Potak Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1508694720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 SPINDLE RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016248",
            "telephone_number": "516-647-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 SPINDLE RD",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118016248",
            "telephone_number": "516-647-1813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTAK",
        "first_name": "SHAWN",
        "middle_name": "JESSICA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "POTAK",
            "credential": "SHAMAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Carol Pollock, LMHC, CASAC-2, NCC
• Suma Sundersen Pondicherry Chandersen, PT
• Lisa Renee Pope
• Melissa Ann Poretsky, MS,SPED
• Joelle B Porush
• Maryann J Pottanat, LICSW
• Alicia Camille Powell
• Tamara Prampin
• Precision Neurological Care PLLC
• Preferred MRI, PC

• Health & Wellness Coach in Hicksville, NY
• Providers in Hicksville, NY by specialty
• Health & Wellness Coach in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.