Active NPI
Kevin Wayne Potter, D.O.
- Surgery Physician
- Glendale, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 005313
- Practice address
- 7330 N 99TH Ave Ste 200a
Glendale, AZ 85307-3018 - Phone
- (602) 406-3400
- Fax
- (602) 406-0270
- NPI assigned
- Jul 31, 2008
- Last updated
- Jun 8, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 005313 | AZ | Primary |
Addresses
Primary practice location
7330 N 99TH Ave Ste 200a
Glendale, AZ 85307-3018
Mailing address
PO Box 33269
Phoenix, AZ 85067-3269
Phone (602) 406-4786
Other practice location 1
625 N 6th St Ste 402
Phoenix, AZ 85004-3067
Phone (602) 406-8222
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 445137 | Medicaid | AZ | |
| Z199540 | Other | AZ | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
500 W Thomas Rd
680 DHMG St Joseph's Pelvic Pain and Surg
Phoenix, AZ 85013-4235
Phone (602) 406-6017
7330 N 99TH Ave
Glendale, AZ 85307-3003
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 15 |
| Removal of tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Josephs Pathology | Current | Accepting new patients | |
| Sjhmc Physician Services | Current | Accepting new patients | |
| Dignity Health | Past | Accepting new patients | |
| Privia Medical Group Arizona, LLC | Family Medicine | Past | Accepting new patients |
| Dignity Health | Past | Accepting new patients |
Locations
7300 N 99th Ave
Glendale, AZ 85307
Phone (480) 339-5001
7330 N 99th Ave
Ste 200
Glendale, AZ 85307
Phone (602) 406-0033
7330 N 99th Ave
Ste 200A
Glendale, AZ 85307
Phone (602) 406-3400
7330 N 99th Ave
Ste 205
Glendale, AZ 85307
Phone (623) 209-1474
7330 N 99th Ave
Ste 325
Glendale, AZ 85307
Phone (480) 398-7620
222 W Thomas Rd
Ste 301
Phoenix, AZ 85013
Phone (602) 406-6900
350 W Thomas Rd
Phoenix, AZ 85013
Phone (480) 339-5001
500 W Thomas Rd
Ste 230
Phoenix, AZ 85013
Phone (602) 406-6700
500 W Thomas Rd
Ste 400
Phoenix, AZ 85013
Phone (602) 406-3874
500 W Thomas Rd
Ste 680
Phoenix, AZ 85013
Phone (602) 406-6017
500 W Thomas Rd
Ste 750
Phoenix, AZ 85013
Phone (602) 406-1150
File 56765
Los Angeles, CA 90074
Organizations & group practices 6
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba St. Joseph's Faculty Physicians
- Multi-Specialty Clinic/Center
- Phoenix, AZ
- NPI 1326098005
-
dba SJHMC Trauma Services
- Emergency Care Clinic/Center
- Phoenix, AZ
- NPI 1255382412
-
dba Pathology Associates LTD
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
- NPI 1265407738
-
dba St. Joseph's Westgate Medical Center
- General Acute Care Hospital
- Glendale, AZ
- NPI 1992131734
-
- Family Medicine Physician
- Payson, AZ
- NPI 1740459700
-
dba Mercy Medical Center Redding
- General Acute Care Hospital
- Redding, CA
- NPI 1477671535
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St. Josephs Hospital and Medical Center Emergency Dept-Litchfield Park
- Emergency Care Clinic/Center
- Litchfield Park, AZ
- NPI 1265065445
Hospital
-
dba St. Josephs Hospital and Medical Center Emergency Dept-Glendale
- Emergency Care Clinic/Center
- Glendale, AZ
- NPI 1609408665
Hospital
-
dba St. Joseph's Hospital and Medical Center
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1982733655
-
dba St. Joseph's Westgate Medical Center
- General Acute Care Hospital
- Glendale, AZ
- NPI 1992131734
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780876800000",
"number": "1831355643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 33269",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850673269",
"telephone_number": "602-406-4786",
"fax_number": "916-636-4358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7330 N 99TH AVE STE 200A",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853073018",
"telephone_number": "602-406-3400",
"fax_number": "602-406-0270"
}
],
"practiceLocations": [
{
"address_1": "625 N 6th St Ste 402",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850043067",
"country_code": "US",
"telephone_number": "602-406-8222",
"fax_number": "602-604-4722",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POTTER",
"first_name": "KEVIN",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-31",
"last_updated": "2026-06-08",
"certification_date": "2026-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AZ",
"license": "005313",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "445137",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "Z199540",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.