Active NPI
Jancy G Pottanat, MD
- Family Medicine Physician
- Fort Lee, VA
National Provider Identifier
1760550800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0101263501
- Practice address
- 700 24TH St
Fort Lee, VA 23801-1716 - Phone
- (804) 734-9910
- Fax
- (804) 734-9594
- NPI assigned
- Nov 30, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101263501 | VA | Primary |
Addresses
Primary practice location
700 24TH St
Fort Lee, VA 23801-1716
Mailing address
700 24TH St
Fort Lee, VA 23801-1716
Phone (804) 734-9910
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101263501 | VA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651622400000",
"number": "1760550800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 24TH ST",
"city": "FORT LEE",
"state": "VA",
"postal_code": "238011716",
"telephone_number": "804-734-9910",
"fax_number": "804-734-9594"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 24TH ST",
"city": "FORT LEE",
"state": "VA",
"postal_code": "238011716",
"telephone_number": "804-734-9910",
"fax_number": "804-734-9594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTANAT",
"first_name": "JANCY",
"middle_name": "G",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2022-05-04",
"certification_date": "2022-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101263501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.