Active NPI
Camella M Potter, N.D.
- Naturopath
- Salem, OR
National Provider Identifier
1669811204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 1959
- Practice address
- 605 Union St NE
Salem, OR 97301-2462 - Phone
- (971) 207-3680
- Fax
- (503) 339-9585
- NPI assigned
- Jun 17, 2013
- Last updated
- Mar 17, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 1959 | OR | Primary |
Addresses
Primary practice location
605 Union St NE
Salem, OR 97301-2462
Mailing address
605 Union St NE
Salem, OR 97301-2462
Phone (503) 804-4730
Other practice location 1
8375 SW Beaverton Hillsdale Hwy Ste A
Portland, OR 97225-2252
Phone (503) 206-6996
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500665861 | Medicaid | OR | |
| 500672146 | Medicaid | OR | |
| 1396159109 | Other | NPI2 |
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 |
|---|---|---|---|
| 1959 | OR | MD | Naturopath |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephanie K Farrell ND, LLC | Naturopath | Past | Accepting new patients |
| Deep Roots Family Medicine | Naturopath | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Naturopath
- Salem, OR
- NPI 1871013409
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1669811204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 UNION ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973012462",
"telephone_number": "503-804-4730",
"fax_number": "888-959-9018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 UNION ST NE",
"city": "SALEM",
"state": "OR",
"postal_code": "973012462",
"telephone_number": "971-207-3680",
"fax_number": "503-339-9585"
}
],
"practiceLocations": [
{
"address_1": "8375 SW Beaverton Hillsdale Hwy Ste A",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "972252252",
"country_code": "US",
"telephone_number": "503-206-6996",
"fax_number": "888-959-9018",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POTTER",
"first_name": "CAMELLA",
"middle_name": "M",
"credential": "N.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-17",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "OR",
"license": "1959",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500665861",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500672146",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI2",
"identifier": "1396159109",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.