Active NPI
Terence Kevin Potts, LMT. LLCC
- Mechanotherapist
- Hailey, ID
National Provider Identifier
1669664488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- 2896
- Practice address
- 16 W Croy St
Suite K
Hailey, ID 83333-9700 - Phone
- (208) 450-7665
- NPI assigned
- Aug 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | 2896 | NM | Primary |
Addresses
Primary practice location
16 W Croy St
Suite K
Hailey, ID 83333-9700
Mailing address
PO Box 3943
Hailey, ID 83333-3943
Phone (208) 450-7665
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 |
|---|---|---|---|
| 2896 | NM | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187136000000",
"number": "1669664488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3943",
"city": "HAILEY",
"state": "ID",
"postal_code": "833333943",
"telephone_number": "208-450-7665",
"fax_number": "208-578-2052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 W CROY ST",
"address_2": "SUITE K",
"city": "HAILEY",
"state": "ID",
"postal_code": "833339700",
"telephone_number": "208-450-7665"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTS",
"first_name": "TERENCE",
"middle_name": "KEVIN",
"name_prefix": "Mr.",
"credential": "LMT. LLCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-08-15",
"last_updated": "2007-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "NM",
"license": "2896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hailey, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.