Individual provider Active NPI

Donna M Potts, MD

  • Internal Medicine Physician
  • Anderson, SC
National Provider Identifier
1659401669
Registry record updated Nov 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11032 Issued in SC
Practice address
118 Montgomery Dr
Anderson, SC 29621-3334
Phone
(864) 512-3879
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11032 SC Primary

Addresses

Primary practice location

118 Montgomery Dr
Anderson, SC 29621-3334

Mailing address

PO Box 2047
Anderson, SC 29622-2047
Phone (864) 512-3879

Other identifiers 1

IdentifierTypeStateIssuer
110329MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100804000002 SC Practitioner - Internal MedicinePractitioner - Infectious Disease 8022014216 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11032SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Anmed Health CurrentSince Jul 13, 2010 Accepting new patients
Anmed Health CurrentSince Jul 13, 2010 Accepting new patients
Anmed Health Current Accepting new patients
Long'S Drugstores of South Carolina, Inc. PastSince Nov 1, 2016 Accepting new patients

Locations

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

1100 W Franklin St
Anderson, SC 29624
Phone (864) 224-0822

109 Essex Dr
Anderson, SC 29621
Phone (864) 512-3879

414 N Fant St
Anderson, SC 29621
Phone (203) 247-9535

Organizations & group practices 4

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447286400000",
    "number": "1659401669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2047",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296222047",
            "telephone_number": "864-512-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MONTGOMERY DR",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296213334",
            "telephone_number": "864-512-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "DONNA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2015-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "11032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110329",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.