Active NPI
Nicole Renae Potts, LCSW
- Social Worker
- Jonesboro, AR
National Provider Identifier
1659442093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 10127-C
- Practice address
- 151 Southwest Dr
Jonesboro, AR 72401-5828 - Phone
- (870) 932-0090
- Fax
- (870) 930-9336
- NPI assigned
- Nov 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 10127-M | AR | |
| Speech-Language Pathologist | 235Z00000X | SP#1761 | AR | |
| Social Worker | 104100000X | 10127-C | AR | Primary |
Addresses
Primary practice location
151 Southwest Dr
Jonesboro, AR 72401-5828
Mailing address
321 Dunwoody Dr
Jonesboro, AR 72404-8889
Phone (870) 930-6372
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 142215721 | Medicaid | AR | |
| SP 5W442 | Other | AR | BCBS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10127-C | AR | MD | Social Worker |
| 10127-M | AR | MD | Social Worker |
| SP#1761 | AR | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Communication Made Easy Inc | Social Worker | Current | Accepting new patients |
Locations
151 Southwest Dr
Jonesboro, AR 72401
Phone (870) 932-0090
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": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1659442093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 DUNWOODY DR",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724048889",
"telephone_number": "870-930-6372",
"fax_number": "870-930-9336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 SOUTHWEST DR",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724015828",
"telephone_number": "870-932-0090",
"fax_number": "870-930-9336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTS",
"first_name": "NICOLE",
"middle_name": "RENAE",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-09",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "10127-M",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP#1761",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "10127-C",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "142215721",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "SP 5W442",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.