Individual provider Active NPI

Kerry Potter

  • Registered Dietitian
  • Tacoma, WA
National Provider Identifier
1811244072
Registry record updated Nov 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Practice address
Madigan Ary Medical Ctr
9040 Reid Street, Attn: MCHJ-CLQ-C
Tacoma, WA 98431-1100
Phone
(253) 968-2252
Fax
(253) 968-3278
NPI assigned
Aug 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

Madigan Ary Medical Ctr
9040 Reid Street, Attn: MCHJ-CLQ-C
Tacoma, WA 98431-1100

Mailing address

Madigan Ary Medical Ctr
9040 Reid Street, Attn: MCHJ-CLQ-C
Tacoma, WA 98431-1100
Phone (253) 968-2252

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

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384905600000",
    "number": "1811244072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARY MEDICAL CTR",
            "address_2": "9040 REID STREET, ATTN: MCHJ-CLQ-C",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-2252",
            "fax_number": "253-968-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARY MEDICAL CTR",
            "address_2": "9040 REID STREET, ATTN: MCHJ-CLQ-C",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-2252",
            "fax_number": "253-968-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "KERRY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2013-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; 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.