Timothy Van Dyke Potts, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

10892 Issued in CA

Practice address

1240 Powell St
Suite 2a
Emeryville, CA 94608-2600

Phone

(510) 725-8791

Fax

(866) 268-1114

NPI assigned

Jan 24, 2013

Sex

Male

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

• Teo Van Dyke Potts Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1538407663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 POWELL ST",
            "address_2": "SUITE 2A",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082600",
            "telephone_number": "510-725-8791",
            "fax_number": "866-268-1114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 POWELL ST",
            "address_2": "SUITE 2A",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082600",
            "telephone_number": "510-725-8791",
            "fax_number": "866-268-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "TIMOTHY",
        "middle_name": "VAN DYKE",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "10892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TEO",
            "last_name": "POTTS",
            "middle_name": "VAN DYKE",
            "credential": "L.AC.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Acupuncturist in Emeryville, CA
• Providers in Emeryville, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.