Leigh Anne Potts, ARNP

Individual provider Active NPI Pediatric Nurse Practitioner · Malabar, FL

NPI 1801289707 · NPPES record last updated Mar 17, 2015

Key facts

NPI
1801289707
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
ARNP9198950 (FL)
Practice address
775 Malabar Rd
Malabar, FL 32950-3120
Phone
(321) 722-8435
Fax
(321) 722-8486
NPI assigned
Mar 17, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150529000974 FL Order and Referring Only - Nurse Practitioner 2769702935

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brevard Health Alliance Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: leigh.potts@bha.eclinicaldirectplus.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP9198950 FL Yes

Addresses

Primary practice location

775 Malabar Rd
Malabar, FL 32950-3120

Mailing address

PO Box 1137
Melbourne, FL 32902-1137
Phone (321) 952-9696

Other providers in Malabar, FL

All providers in Malabar, FL · Pediatric Nurse Practitioner in Florida

Sources for this page

Verify at the official NPI Registry.