Mandy M Potter, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0102203220 Issued in VA

Practice address

4685 Belding Rd NE
Rockford, MI 49341

Phone

(616) 252-3100

Fax

(616) 252-3120

NPI assigned

Jun 14, 2011

Last updated

Feb 13, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpotter106286@direct.metrohealth.net

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.

• McLaren Greater Lansing

  • Gynecologic Oncology Physician
  • Lansing, MI
  • NPI 1265600902
  Medicare reassignment NPD
• Metropolitan Hospital

  dba Metro Health Hospital

  • Internal Medicine Physician
  • Wyoming, MI
  • NPI 1811937519
  Medicare reassignment NPD
• McLaren Greater Lansing

  • Psychologist
  • Lansing, MI
  • NPI 1558556332

  Pediatrics

  NPD
• McLaren Greater Lansing

  • Family Medicine Physician
  • Lansing, MI
  • NPI 1962808162
  NPD
• McLaren Greater Lansing

  • General Acute Care Hospital
  • Lansing, MI
  • NPI 1134104672
  NPD (past)

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1588959878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199606",
            "telephone_number": "616-252-3243",
            "fax_number": "616-252-0260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4685 BELDING RD NE",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "49341",
            "telephone_number": "616-252-3100",
            "fax_number": "616-252-3120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Brewster Blvd",
            "address_2": "Naval Hospital",
            "address_purpose": "LOCATION",
            "city": "Camp Lejeune",
            "state": "NC",
            "postal_code": "285472538",
            "country_code": "US",
            "telephone_number": "910-450-4161",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Brewster Blvd",
            "address_2": "Naval Hospital",
            "address_purpose": "LOCATION",
            "city": "Camp Lejeune",
            "state": "NC",
            "postal_code": "285472538",
            "country_code": "US",
            "telephone_number": "910-450-4161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTER",
        "first_name": "MANDY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0102203220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Powerback Rehabilitation LLC
• Tracy A Powers, DPT
• Brittney Marquee Powrozek
• Prevos Family Markets LLC (Family Fare Pharmacy #1572)
• Kristen Ann Priem, BCBA

• Pediatrics Physician in Rockford, MI
• Providers in Rockford, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.