Active NPI
Ellis Brian Potter, PH.D.
- Clinical Psychologist
- Aurora, CO
National Provider Identifier
1649211608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 317
- Practice address
- 18846 E Saratoga Cir
Aurora, CO 80015-4932 - Phone
- (303) 693-3630
- Fax
- (303) 627-1573
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 317 | CO | Primary |
Addresses
Primary practice location
18846 E Saratoga Cir
Aurora, CO 80015-4932
Mailing address
18846 E Saratoga Cir
Aurora, CO 80015-4932
Phone (303) 693-3630
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 317 | CO | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affilitated Therapeutic Services, PC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649211608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18846 E SARATOGA CIR",
"city": "AURORA",
"state": "CO",
"postal_code": "800154932",
"telephone_number": "303-693-3630",
"fax_number": "303-627-1573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18846 E SARATOGA CIR",
"city": "AURORA",
"state": "CO",
"postal_code": "800154932",
"telephone_number": "303-693-3630",
"fax_number": "303-627-1573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "ELLIS",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CO",
"license": "317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
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.