NPIMap

Individual provider Active NPI

Lisa Marie Potthoff, NP-C

  • Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1629782479
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2023000172 Issued in MO
Practice address
3801 S National Ave Ste 900
Springfield, MO 65807-5210
Phone
(417) 875-3087
Fax
(417) 875-3594
NPI assigned
Jan 6, 2023
Last updated
Feb 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2023000172 MO Primary

Addresses

Primary practice location

3801 S National Ave Ste 900
Springfield, MO 65807-5210

Mailing address

PO Box 802843
Kansas City, MO 64180-2843

Other identifiers 1

IdentifierTypeStateIssuer
420118950MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230123002684 MO Practitioner - Nurse Practitioner 1254702673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lester E Cox Medical CentersGroup PAC ID 1254248917, 336 clinicians

Practice addresses (Care Compare)

3801 S National
Suite 900
Springfield, MO 65807-5210
Phone (417) 875-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.52 of 100Reported as group
Quality
61.64
Promoting interoperability
100
Improvement activities
40
Cost
76.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lester E Cox Medical Centers CurrentSince Feb 27, 2023 Accepting new patients
Lester E Cox Medical Centers Current Accepting new patients
Lester E Cox Medical Centers Past Accepting new patients

Locations

1000 E Primrose St
Ste 360
Springfield, MO 65807
Phone (417) 269-4037

3800 S National Ave
Ste 400
Springfield, MO 65807
Phone (417) 269-9842

3801 S National Ave
Ste 900
Springfield, MO 65807
Phone (417) 269-2710

Organizations & group practices 3

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1672963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1629782479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 802843",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641802843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE STE 900",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-875-3087",
            "fax_number": "417-875-3594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTHOFF",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-06",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2023000172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420118950",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.