Robert Edward Potter Jr., DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301005410 Issued in MI

Practice address

6231 N Canton Center Rd
Ste 109
Canton, MI 48187-2694

Phone

(734) 455-6767

Fax

(734) 455-2359

NPI assigned

Aug 19, 2005

Last updated

Apr 2, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

National College of Chiropractic, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Robert Edward Potter Jr DC PLLCGroup PAC ID 3476562059, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Robert Edward Potter Jr DC PLLC

  dba Canton Center Chiropractic Clinic

  • Chiropractor
  • Canton, MI
  • NPI 1114919016
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1649262254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6231 N CANTON CENTER RD",
            "address_2": "STE 109",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872694",
            "telephone_number": "734-455-6767",
            "fax_number": "734-455-2359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6231 N CANTON CENTER RD",
            "address_2": "STE 109",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481872694",
            "telephone_number": "734-455-6767",
            "fax_number": "734-455-2359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "ROBERT",
        "middle_name": "EDWARD",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portable Smiles Consulting LLC
• Portable Smiles Mobile Inc
• Inez Porter, LLMSW, MSW
• Danielle Patrice Potter-Bodenlos, D.C.
• Jessie L Potter, DC
• Gerald Powell, DPT
• Joseph Carter Powers
• Dorota Poznanska-Frederick, MA, LLP
• Laxmi P. Prabhu, M.D.
• Prabhu, LLC

• Chiropractor in Canton, MI
• Providers in Canton, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.