Susan Kaye Potter, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

424709 Issued in CA

Practice address

11201 Benton St
Loma Linda, CA 92357-1000

Phone

(800) 741-8387

Fax

(909) 777-3291

NPI assigned

Aug 30, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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 and National Provider Directory roles.

• QHP a Professional Corporation

  • Health Service Clinic/Center
  • Santa Ana, CA
  • NPI 1053187187
  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669581757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1839 KINGSBURY DR",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923741710",
            "telephone_number": "800-741-8387",
            "fax_number": "909-777-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 BENTON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923571000",
            "telephone_number": "800-741-8387",
            "fax_number": "909-777-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "SUSAN",
        "middle_name": "KAYE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "424709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Lauren Pope, MD
• Prashanth Porayette, MD
• Karen Portillo, RN
• Vivien Lee Posner, MD
• Breanna Louise Potenciano
• Minerva Marlene Pouchoulen
• Theodore Powers, M.D.
• Florence S Pragasam, N.P.
• Pramod S Kulkarni MD Inc
• Vinoy Singh Prasad, MD

• Family Nurse Practitioner in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.