NPIMap

Individual provider Active NPI

Chrystal Lynn Potter, M.D.

  • Internal Medicine Physician
  • Glendive, MT
National Provider Identifier
1649433293
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
33767 Issued in MT
Practice address
107 Dilworth St
Glendive, MT 59330-2053
Phone
(406) 345-8901
NPI assigned
Jul 3, 2008
Last updated
Jun 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 33767 MT Primary
Pediatrics Physician 208000000X 33767 MT

Addresses

Primary practice location

107 Dilworth St
Glendive, MT 59330-2053

Mailing address

107 Dilworth St
Glendive, MT 59330-2053
Phone (406) 345-8901

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20140902002078 MT Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6800931809 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Kentucky College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gabert Medical Services IncGroup PAC ID 2668385402, 23 clinicians
Glendive Medical Center IncGroup PAC ID 7214846823, shared by 6 NPIs, 16 clinicians

Practice addresses (Care Compare)

107 Dilworth St
Glendive, MT 59330-2053
Phone (406) 345-8901

202 Prospect Dr
Glendive, MT 59330-1943
Phone (406) 345-3306

202 Prospect Dr
Glendive, MT 59330-1999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33767MTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glendive Medical Center, Inc Current Accepting new patients
Glendive Medical Center, Inc CurrentSince Oct 1, 2020 Accepting new patients
Glendive Medical Center, Inc CurrentSince Oct 1, 2020 Accepting new patients
Glendive Medical Center, Inc CurrentSince Jan 1, 2016 Accepting new patients
Gabert Medical Services, Inc CurrentSince Jul 7, 2014 Accepting new patients
Glendive Medical Center, Inc Current Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

107 Dilworth St
Glendive, MT 59330
Phone (406) 345-8900

202 Prospect Dr
Glendive, MT 59330
Phone (406) 345-3306

Interoperability endpoints

  • Direct secure messaging: cpotter@gmc.cernerdirect.com

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Glendive Medical Center Inc.Glendive, MT, CCN 271332 Hospital Corporate Director Jan 1, 2016
Glendive Medical Center IncGlendive, MT, CCN 27Z332 Hospital Corporate Director Jan 1, 2016
Glendive Medical Center Nursing HomeGlendive, MT, CCN 275067 Skilled nursing facility Corporate Director Jan 1, 2016
Glendive Medical Center HospiceGlendive, MT, CCN 271517 Hospice Corporate Director Jan 1, 2016
Gabert ClinicGlendive, MT, CCN 273411 Rural health clinic Corporate Director Jan 1, 2016

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 11

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

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1649433293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 DILWORTH ST",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593302053",
            "telephone_number": "406-345-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 DILWORTH ST",
            "city": "GLENDIVE",
            "state": "MT",
            "postal_code": "593302053",
            "telephone_number": "406-345-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "CHRYSTAL",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-03",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "33767",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MT",
            "license": "33767",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendive, MT

Sources for this page

Verify at the official NPI Registry.