Individual provider Active NPI

John S Potts, DO

  • Family Medicine Physician
  • West Chester, PA
National Provider Identifier
1710919014
Registry record updated Mar 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0S010013L Issued in PA
Practice address
1055 Andrews Ave
Suite B
West Chester, PA 19380
Phone
(610) 436-4448
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0S010013L PA Primary

Addresses

Primary practice location

1055 Andrews Ave
Suite B
West Chester, PA 19380

Mailing address

1055 Andrews Ave
Suite B
West Chester, PA 19380

Other identifiers 1

IdentifierTypeStateIssuer
0018075290001MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100311000734 PA Practitioner - Family Practice 8628103934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Main Line HealthcareGroup PAC ID 1951215201, 1,154 clinicians

Practice addresses (Care Compare)

1991 Sproul Rd
Broomall, PA 19008-3512
Phone (610) 353-5079

830 Old Lancaster Rd
Bryn Mawr, PA 19010-3118

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0S010013LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare Family Medicine CurrentSince Nov 1, 2018 Accepting new patients
Urologic Associates of Chester County, Inc.. Past Accepting new patients

Locations

1991 Sproul Rd
Ste 140
Broomall, PA 19008
Phone (610) 325-0309

830 Old Lancaster Rd
Ste 108
Bryn Mawr, PA 19010
Phone (610) 520-5200

3803 West Chester Pike
Ste 160
Newtown Square, PA 19073
Phone (484) 337-1530

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300838400000",
    "number": "1710919014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 ANDREWS AVE",
            "address_2": "SUITE B",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "19380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 ANDREWS AVE",
            "address_2": "SUITE B",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "19380",
            "telephone_number": "610-436-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2011-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "0S010013L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018075290001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

Verify at the official NPI Registry.