Active NPI
Olivia Marie Potter, FNP
- Family Nurse Practitioner
- Syracuse, NY
National Provider Identifier
1750014619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- SP025701
- Practice address
- 195 Intrepid LN
Syracuse, NY 13205-2544 - Phone
- (844) 315-2229
- NPI assigned
- Jul 7, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 996706 | NY | |
| Nurse Practitioner | 363L00000X | 357355 | NY | |
| Registered Nurse | 163W00000X | RN710925 | PA | |
| Nurse Practitioner | 363L00000X | 0024189270 | VA | |
| Family Nurse Practitioner | 363LF0000X | SP025701 | PA | Primary |
| Registered Nurse | 163W00000X | 0001275861 | VA |
Addresses
Primary practice location
195 Intrepid LN
Syracuse, NY 13205-2544
Mailing address
158 Evergreen LN
Catawissa, PA 17820-8239
Phone (570) 204-0329
Other practice location 1
6315 N Center Dr Ste 202
Norfolk, VA 23502-4006
Phone (244) 315-2229
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 996706 | NY | MD | Registered Nurse |
| RN710925 | PA | MD | Registered Nurse |
| 0001275861 | VA | MD | Registered Nurse |
| 357355 | NY | MD | Nurse Practitioner |
| 0024189270 | VA | MD | Nurse Practitioner |
| SP025701 | PA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772582400000",
"number": "1750014619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "158 EVERGREEN LN",
"city": "CATAWISSA",
"state": "PA",
"postal_code": "178208239",
"telephone_number": "570-204-0329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 INTREPID LN",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132052544",
"telephone_number": "844-315-2229"
}
],
"practiceLocations": [
{
"address_1": "6315 N Center Dr Ste 202",
"address_purpose": "LOCATION",
"city": "Norfolk",
"state": "VA",
"postal_code": "235024006",
"country_code": "US",
"telephone_number": "244-315-2229",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POTTER",
"first_name": "OLIVIA",
"middle_name": "MARIE",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-07",
"last_updated": "2026-03-04",
"certification_date": "2026-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "996706",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "NY",
"license": "357355",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "PA",
"license": "RN710925",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "VA",
"license": "0024189270",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "PA",
"license": "SP025701",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "VA",
"license": "0001275861",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.