Active NPI
Brian William Potter, ATC, EMT, OTC
- Athletic Trainer
- Elkins, WV
National Provider Identifier
1699982447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT001028
- Practice address
- 1502 Harrison Ave
Elkins, WV 26241-3497 - Phone
- (304) 637-4509
- NPI assigned
- May 17, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT001028 | WV | Primary |
Addresses
Primary practice location
1502 Harrison Ave
Elkins, WV 26241-3497
Mailing address
19 Woody Dr
Buckhannon, WV 26201-2437
Phone (304) 671-6780
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
- Credentials
- Emergency Medical Technician
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT001028 | WV | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tygart Valley Orthopedics and Sports Medicine, Inc. | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/1404/brand/1/csg/1/fhir/r4
Organizations & group practices 1
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.
-
- Specialist
- Elkins, WV
- NPI 1659391472
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481846400000",
"number": "1699982447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 WOODY DR",
"city": "BUCKHANNON",
"state": "WV",
"postal_code": "262012437",
"telephone_number": "304-671-6780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 HARRISON AVE",
"city": "ELKINS",
"state": "WV",
"postal_code": "262413497",
"telephone_number": "304-637-4509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "BRIAN",
"middle_name": "WILLIAM",
"credential": "ATC, EMT, OTC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2016-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WV",
"license": "AT001028",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkins, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.