Jackie L Potts, M.A.CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP0000001594 Issued in TN

Practice address

600 N Holtzclaw - Suite 200
Chattanooga, TN 37404-1240

Phone

(426) 622-6900

Fax

(423) 622-4834

NPI assigned

Jul 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Speech and Hearing Center

  • Audiologist
  • Chattanooga, TN
  • NPI 1386667822

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1699781716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N HOLTZCLAW - SUITE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041240",
            "telephone_number": "423-622-6900",
            "fax_number": "423-622-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N HOLTZCLAW - SUITE 200",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374041240",
            "telephone_number": "426-622-6900",
            "fax_number": "423-622-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "JACKIE",
        "middle_name": "L",
        "credential": "M.A.CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "SP0000001594",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP004960",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4000592",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST",
            "identifier": "4000592",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "4640001",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prabhu K Potluri, M.D.
• Donald R. Potter, FNP-BC
• Jack R Potter, D.PH.
• Wendy J Potter, RN
• Danielle Christine Potts, DPT
• Jill Pouncey, M.S., C.G.C.
• John Pound, FNP-C
• Sarah Falk Powe, OT
• Cari Alexandria Powell, MSN, FNP-BC
• Carisa Ozell Powell, LPC-MHSP

• Speech-Language Pathologist in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.