Individual provider Active NPI

Carl R Potts, MD

  • Emergency Medicine Physician
  • Moncks Corner, SC
National Provider Identifier
1609882844
Registry record updated Aug 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
14480 Issued in SC
Practice address
730 Stony Landing Rd
Moncks Corner, SC 29461
Phone
(843) 797-7000
NPI assigned
Jul 31, 2006
Last updated
Aug 26, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 14480 SC Primary

Addresses

Primary practice location

730 Stony Landing Rd
Moncks Corner, SC 29461

Mailing address

PO Box 751137
Charlotte, NC 28275-1137
Phone (866) 448-1640

Other identifiers 1

IdentifierTypeStateIssuer
G34689MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040331000731 SC Practitioner - Emergency Medicine 1153313150 Reassigns benefits to 4 organizations
I20240530003139 NC Practitioner - Emergency Medicine 1153313150 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
84.15 of 100Reported as group
Quality
81.36
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14480SCMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Hospital Inc. CurrentSince Jan 1, 2004 Accepting new patients
Roper Hospital Inc Emergency Medicine Current Accepting new patients
Ballantyne Emergency Physicians PLLC Emergency Medicine CurrentSince Aug 10, 2024 Accepting new patients
Musc Community Physicians CurrentSince Feb 1, 2024 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Jun 1, 2024 Accepting new patients
Ballantyne Emergency Physicians PLLC Emergency Medicine CurrentSince Aug 10, 2024 Accepting new patients
Roper St. Francis Mount Pleasant Hospital CurrentSince Nov 24, 2020 Accepting new patients
Roper St. Francis Mount Pleasant Hospital Current Accepting new patients
Roper St. Francis Mount Pleasant Hospital Emergency Medicine CurrentSince Nov 24, 2020 Accepting new patients
Bon Secours St Francis Xavier Hospital, Inc. Emergency Medicine CurrentSince Nov 24, 2020 Accepting new patients
Musc Community Physicians Emergency Medicine Current Accepting new patients
Roper Hospital Inc Emergency Medicine CurrentSince Jan 1, 2004 Accepting new patients
Bon Secours St. Francis Xavier Hospital, Inc. CurrentSince Nov 24, 2020 Accepting new patients
Musc Community Physicians CurrentSince Feb 1, 2024 Accepting new patients
Roper Hospital, Inc. Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

11516 Providence Rd
Charlotte, NC 28277
Phone (704) 667-0370

16035 Johnston Rd
Charlotte, NC 28277
Phone (704) 542-5132

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

2095 Henry Tecklenburg Dr
Charleston, SC 29414
Phone (843) 402-1037

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

730 Stony Landing Rd
Moncks Corner, SC 29461
Phone (843) 572-9211

3500 N Highway 17
Mt Pleasant, SC 29466
Phone (843) 606-7000

570 Long Point Rd
Ste 150
Mt Pleasant, SC 29464
Phone (843) 480-2273

Interoperability endpoints

  • Direct secure messaging: cpotts2951657@carolinashealthcaresystem.direct-ci.com
  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251244800000",
    "number": "1609882844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751137",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751137",
            "telephone_number": "866-448-1640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 STONY LANDING RD",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "29461",
            "telephone_number": "843-797-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "CARL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2009-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "14480",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G34689",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moncks Corner, SC

Sources for this page

Verify at the official NPI Registry.