Active NPI
Rickendra Brooke Potter, OTR/L
- Occupational Therapist
- Pineville, KY
National Provider Identifier
1689334153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 274257
- Practice address
- 39 Ferndale Apartments Rd
Pineville, KY 40977-8578 - Phone
- (606) 337-7071
- NPI assigned
- Dec 27, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 7079 | TN | |
| Occupational Therapist | 225X00000X | 274257 | KY | Primary |
Addresses
Primary practice location
39 Ferndale Apartments Rd
Pineville, KY 40977-8578
Mailing address
636 Old Bell High Rd
Pineville, KY 40977-8239
Phone (606) 499-7730
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 |
|---|---|---|---|
| 7079 | TN | MD | Physical Therapist |
| 274257 | KY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1640563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640563200000",
"number": "1689334153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "636 OLD BELL HIGH RD",
"city": "PINEVILLE",
"state": "KY",
"postal_code": "409778239",
"telephone_number": "606-499-7730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39 FERNDALE APARTMENTS RD",
"city": "PINEVILLE",
"state": "KY",
"postal_code": "409778578",
"telephone_number": "606-337-7071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "RICKENDRA",
"middle_name": "BROOKE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-27",
"last_updated": "2021-12-27",
"certification_date": "2021-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "7079",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KY",
"license": "274257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pineville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.