Individual provider Active NPI

Nancy Ann Potempa, LADC

  • Addiction (Substance Use Disorder) Counselor
  • Saint Paul, MN
National Provider Identifier
1790047447
Registry record updated Jun 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
303111 Issued in MN
Practice address
1749 Randolph Ave
#2
Saint Paul, MN 55105-2154
Phone
(651) 293-0721
NPI assigned
Jun 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 303111 MN Primary

Addresses

Primary practice location

1749 Randolph Ave
#2
Saint Paul, MN 55105-2154

Mailing address

1749 Randolph Ave
#2
Saint Paul, MN 55105-2154
Phone (651) 293-0721

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
303111MNMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339113600000",
    "number": "1790047447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 RANDOLPH AVE",
            "address_2": "#2",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052154",
            "telephone_number": "651-293-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 RANDOLPH AVE",
            "address_2": "#2",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551052154",
            "telephone_number": "651-293-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTEMPA",
        "first_name": "NANCY",
        "middle_name": "ANN",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-08",
        "last_updated": "2012-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.