Potomac Square Family Medicine, LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

POTOMAC SQUARE FAMILY MEDICINE, LLC

Practice address

13650 E Mississippi Ave Ste 110
Aurora, CO 80012-3573

Phone

(303) 695-8684

Fax

(303) 597-0191

NPI assigned

May 23, 2006

Organization subpart

No

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

Authorized official

Name

Stephanie Gluchacki

Title

SVP, Compliance

Phone

(508) 689-9706

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1740235548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 173848",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802173848",
            "telephone_number": "303-945-3299",
            "fax_number": "303-341-4708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13650 E MISSISSIPPI AVE STE 110",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800123573",
            "telephone_number": "303-695-8684",
            "fax_number": "303-597-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC SQUARE FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "GLUCHACKI",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "SVP, COMPLIANCE",
        "authorized_official_telephone_number": "508-689-9706"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77404343",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Poteat, PNP
• Ann Poteet, AGNP-C
• Shravya Reddy Pothula
• Valeria L Potigailo, MD
• Potomac Pharmacy and Medical Supply
• Aimee K Potter, LCSW
• Brad Potter, D.D.S.
• Ellis Brian Potter, PH.D.
• Heather Potter
• Jennifer Potter

• Primary Care Clinic/Center in Aurora, CO
• Providers in Aurora, CO by specialty
• Primary Care Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.