Individual provider Active NPI

Benjamin David Potter, M.D.

  • Psychiatry Physician
  • Charleston, SC
National Provider Identifier
1821382748
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
LL33580 Issued in SC
Practice address
169 Ashley Ave
Room 202 Main Hospital, Msc333
Charleston, SC 29425-8905
Phone
(843) 792-0192
NPI assigned
Jun 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X LL33580 SC Primary

Addresses

Primary practice location

169 Ashley Ave
Room 202 Main Hospital, Msc333
Charleston, SC 29425-8905

Mailing address

169 Ashley Ave
Room 202 Main Hospital, Msc333
Charleston, SC 29425-8905
Phone (843) 792-0192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200601003001 SC Practitioner - Psychiatry 8527357698 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Kentucky College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Carolina Dept of Mental Health Accounting OfficeGroup PAC ID 9032021175, shared by 11 NPIs, 226 clinicians

Practice addresses (Care Compare)

220 Faison Dr
Columbia, SC 29203-3210
Phone (803) 898-8415

250 Dewey Ave
Spartanburg, SC 29303-3009
Phone (864) 858-0366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL33580SCMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office Psychiatry CurrentSince Aug 4, 2020 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Aug 4, 2020 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Psychiatry CurrentSince Aug 3, 2024 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office Psychiatry Current Accepting new patients

Locations

220 Faison Dr
Columbia, SC 29203
Phone (803) 898-1662

2414 Bull St
Columbia, SC 29201
Phone (803) 898-2461

125 E Robinson St
Gaffney, SC 29340
Phone (864) 487-2710

250 Dewey Ave
Spartanburg, SC 29303
Phone (864) 585-0366

Interoperability endpoints

  • Direct secure messaging: bpotter1907@direct.musc.edu

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1821382748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "address_2": "ROOM 202 MAIN HOSPITAL, MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE",
            "address_2": "ROOM 202 MAIN HOSPITAL, MSC333",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905",
            "telephone_number": "843-792-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-08",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "LL33580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.