Individual provider Active NPI

Brad Potts, PH.D.

  • Psychologist
  • Lima, OH
National Provider Identifier
1598170102
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5623 Issued in OH
Practice address
1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone
(419) 998-4575
Fax
(419) 998-4586
NPI assigned
Jun 23, 2014
Last updated
Mar 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5623 OH Primary

Addresses

Primary practice location

1001 Bellefontaine Ave
Lima, OH 45804-2800

Mailing address

1001 Bellefontaine Ave
Lima, OH 45804-2800
Phone (419) 998-4575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Professional Corporation CurrentSince Feb 1, 2022 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

L3982
Columbus, OH 43260

1001 Bellefontaine Ave
Lima, OH 45804
Phone (419) 228-3335

1005 Bellefontaine Ave
Ste 345
Lima, OH 45804
Phone (419) 224-8223

Organizations & group practices 2

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": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1598170102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 BELLEFONTAINE AVE",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042800",
            "telephone_number": "419-998-4575",
            "fax_number": "419-998-4586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BELLEFONTAINE AVE",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458042800",
            "telephone_number": "419-998-4575",
            "fax_number": "419-998-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "BRAD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-23",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "5623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

Verify at the official NPI Registry.