Individual provider Active NPI

Olivia Marie Potter, FNP

  • Family Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1750014619
Registry record updated Mar 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP025701 Issued in PA
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

Updated by the provider on Mar 4, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
996706NYMDRegistered Nurse
RN710925PAMDRegistered Nurse
0001275861VAMDRegistered Nurse
357355NYMDNurse Practitioner
0024189270VAMDNurse Practitioner
SP025701PAMDFamily 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.

Verify at the official NPI Registry.