Active NPI
Camilla D Potter, M.D.
- Family Medicine Physician
- Allston, MA
National Provider Identifier
1609980507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 70468
- Practice address
- Joseph M. Smith Comm HLTH Ctr
287 Western Avenue
Allston, MA 02134 - Phone
- (617) 783-0500
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 70468 | MA | Primary |
Addresses
Primary practice location
Joseph M. Smith Comm HLTH Ctr
287 Western Avenue
Allston, MA 02134
Mailing address
Joseph M. Smith Comm HLTH Ctr
287 Western Avenue
Allston, MA 02134
Phone (617) 783-0500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 70468 | MA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mt Auburn Professional Services | Past | Accepting new patients | |
| Charles River Community Health Inc | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Brighton, MA
- NPI 1487664884
-
- Obstetrics & Gynecology Physician
- Watertown, MA
- NPI 1407865439
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609980507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "JOSEPH M. SMITH COMM HLTH CTR",
"address_2": "287 WESTERN AVENUE",
"city": "ALLSTON",
"state": "MA",
"postal_code": "02134",
"telephone_number": "617-783-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "JOSEPH M. SMITH COMM HLTH CTR",
"address_2": "287 WESTERN AVENUE",
"city": "ALLSTON",
"state": "MA",
"postal_code": "02134",
"telephone_number": "617-783-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "CAMILLA",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MA",
"license": "70468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Allston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.