Krishnan Potti, M.D. PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01025043A Issued in IN

Practice address

8300 Broadway
Suite B
Merrillville, IN 46410-8602

Phone

(219) 769-4616

NPI assigned

Aug 1, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427155200000",
    "number": "1659387124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 BROADWAY",
            "address_2": "SUITE B",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "46410",
            "telephone_number": "219-769-4616",
            "fax_number": "219-736-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 BROADWAY",
            "address_2": "SUITE B",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108602",
            "telephone_number": "219-769-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTI",
        "first_name": "KRISHNAN",
        "name_prefix": "Dr.",
        "credential": "M.D. PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2015-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01025043A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100158100",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David George Ponessa, PTA
• Kassandra Renee Poplawski, HIS
• Derrick Allen Porter, MSW
• Andrew Portlock
• Carly Ann Posiadlik
• Lynn T Powell, D.C.
• Mary Powell
• Tammy Powell
• Powerback Rehabilitation LLC
• Edgar D Prater

• Internal Medicine Physician in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.