Active NPI
Lisa Potts
- Private Vehicle
- Lagrange, GA
National Provider Identifier
1679006753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- Practice address
- 401A Boulevard
Lagrange, GA 30240 - Phone
- (706) 333-9369
- NPI assigned
- Apr 6, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | GA | Primary | |
| Nurse's Aide | 376K00000X | CN0000047840 | GA |
Addresses
Primary practice location
401A Boulevard
Lagrange, GA 30240
Mailing address
401A Boulevard
Lagrange, GA 30240
Phone (706) 333-9369
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 |
|---|---|---|---|
| CN0000047840 | GA | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491436800000",
"number": "1679006753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401A BOULEVARD",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "30240",
"telephone_number": "706-333-9369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401A BOULEVARD",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "30240",
"telephone_number": "706-333-9369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTS",
"first_name": "LISA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-06",
"last_updated": "2017-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "GA",
"license": null,
"primary": true
},
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "GA",
"license": "CN0000047840",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.