Shannon J Potter, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

2010017998 Issued in MO

Practice address

3466 McKelvey Rd
Bridgeton, MO 63044-2533

Phone

(314) 463-6950

NPI assigned

Jun 10, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Specialty

Obstetrics/Gynecology

Education

University of Texas Medical School at San Antonio, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
• Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180
• SSM Health Depaul Hospital St Louis Hospital, Bridgeton, MO, CCN 260104
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020
• Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: spotter25263@direct-ehr-ssmhc.com
• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Farmington, MO
  • NPI 1427114990
  NPD
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barnes Jewish Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1649299827
  Care Compare affiliation
• Christian Hospital Northeast- Northwest

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1639186760
  Care Compare affiliation
• Christian Hospital Northeast-Northwest

  • Ambulance
  • Saint Louis, MO
  • NPI 1073769329

  Hospital

  Care Compare affiliation
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation
• SSM Health Care St. Louis

  • General Acute Care Hospital
  • Bridgeton, MO
  • NPI 1598835308
  Care Compare affiliation

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

{
    "created_epoch": "1276128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1700106853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 MASON RIDGE CENTER DR STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418512",
            "telephone_number": "314-448-3791",
            "fax_number": "636-996-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3466 MCKELVEY RD",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442533",
            "telephone_number": "314-463-6950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6420 Clayton Rd",
            "address_2": "Suite 291",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631171811",
            "country_code": "US",
            "telephone_number": "314-781-4772 x7",
            "fax_number": "314-645-8771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTTER",
        "first_name": "SHANNON",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-10",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2010017998",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3466 McKelvey Rd",
            "city": "Bridgeton",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630442533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth Joy Polk, MSW
• Ryan J Pomajzl, M.D., P.T., A.T.,C.
• Emily Ponder, PHARMD
• Jaylahni-Tashon Mailena Pope
• Post-Acute Physicians of Missouri PC
• Kathleen M Potts, CPNP
• Karl Potzmann, M.ED.
• Gregory Joe Powell, D.M.D.
• Nicholas A Powers, D.O.
• Christin A Prather, ACNP

• Obstetrics & Gynecology Physician in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Obstetrics & Gynecology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.