Individual provider Active NPI

Charles Eugene Potts, MD

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Melbourne, FL
National Provider Identifier
1689868622
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
License
ME128442 Issued in FL
Practice address
4450 W Eau Gallie Blvd Ste 250
Melbourne, FL 32934-7215
Phone
(321) 751-6671
NPI assigned
Sep 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X ME128442 FL Primary

Addresses

Primary practice location

4450 W Eau Gallie Blvd Ste 250
Melbourne, FL 32934-7215

Mailing address

1975 Snapdragon Dr NW
Palm Bay, FL 32907-7207
Phone (606) 585-5448

Other identifiers 1

IdentifierTypeStateIssuer
024494300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180808000219 FL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0345286332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME128442FLMDHospice and Palliative Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1689868622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 SNAPDRAGON DR NW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329077207",
            "telephone_number": "606-585-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 W EAU GALLIE BLVD STE 250",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329347215",
            "telephone_number": "321-751-6671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "CHARLES",
        "middle_name": "EUGENE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "FL",
            "license": "ME128442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "024494300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.