Ethan Joseph Poteet

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12776 Issued in TN

Practice address

3096 Poplar Ave
Memphis, TN 38111-3532

Phone

(901) 203-6366

Fax

(901) 746-0410

NPI assigned

Jun 3, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Tennessee, HSC, College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hermitage, TN
  • NPI 1104068063
  NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD

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

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1801410048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306393",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306393",
            "telephone_number": "615-373-1350",
            "fax_number": "615-373-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3096 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381113532",
            "telephone_number": "901-203-6366",
            "fax_number": "901-746-0410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7730 Poplar Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383948",
            "country_code": "US",
            "telephone_number": "901-756-4818",
            "fax_number": "901-756-4819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POTEET",
        "first_name": "ETHAN",
        "middle_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-03",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "12776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Positive Transitions, Inc.
• Erin C Poss, FNP
• Roslyn R Postlewaite, LCSW
• Anna Jean Ridge Poston, FNP
• Nicole S Poston, NP
• Alexis Potter, PT, DPT
• Brian S. Potter, PSYD
• Kim Potter, MD
• Timothy Alan Potter, MD
• Jennifer Potts, NP

• Physical Therapist in Memphis, TN
• Providers in Memphis, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.