Individual provider Active NPI

Rachael Marie Potter, RN

  • Registered Nurse
  • Chehalis, WA
National Provider Identifier
1851912141
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60623475 Issued in WA
Practice address
500 SE Washington Ave
Chehalis, WA 98532-3058
Phone
(360) 748-4776
NPI assigned
Apr 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60623475 WA Primary

Addresses

Primary practice location

500 SE Washington Ave
Chehalis, WA 98532-3058

Mailing address

3510 Steelhammer Dr
Centralia, WA 98531-4551
Phone (360) 623-8020

Other identifiers 1

IdentifierTypeStateIssuer
2077844MedicaidWA

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN60623475WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Evaluation and Treatment Center PastSince Dec 6, 2022 Accepting new patients
Cascade Community Healthcare PastSince Dec 6, 2022 Accepting new patients

Organizations & group practices 2

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": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1851912141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 STEELHAMMER DR",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985314551",
            "telephone_number": "360-623-8020",
            "fax_number": "360-623-1072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SE WASHINGTON AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985323058",
            "telephone_number": "360-748-4776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "RACHAEL",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60623475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2077844",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; 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.