Rebecca L. Potter, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24870 Issued in MN

Practice address

343 Woodlake Dr SE
Rochester, MN 55904-6242

Phone

(507) 289-2089

NPI assigned

Jan 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Essentia Health Duluth Hospital, Duluth, MN, CCN 240019

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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 Duluth Clinic LTD

  • Multi-Specialty Clinic/Center
  • Cloquet, MN
  • NPI 1902563638
  Medicare reassignment Care Compare group NPD
• Zumbro Valley Health Center

  • Community/Behavioral Health Agency
  • Rochester, MN
  • NPI 1801961263
  Medicare reassignment NPD
• The Duluth Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Hermantown, MN
  • NPI 1235176058
  NPD
• The Duluth Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Duluth, MN
  • NPI 1245278209
  NPD
• The Duluth Clinic, LTD.

  • Community/Retail Pharmacy
  • Hinckley, MN
  • NPI 1245081066
  NPD

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1700340221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 WOODLAKE DR SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 WOODLAKE DR SE",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559046242",
            "telephone_number": "507-289-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "REBECCA",
        "middle_name": "L.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodora Anne Potretzke, MD
• Amy Rose Potter, OT
• Ashley Potter, PHARMD
• Donald D Potter Jr., M.D.
• Jonathan D Potter, OT
• Audrey Alice Potts, MB BCH BAO
• Charlotte A Pougnier, MD
• Eric A Poulin, M.D.
• Gary Poulson, PA-C
• Alex Powell

• Clinical Social Worker in Rochester, MN
• Providers in Rochester, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.