NPIMap

Individual provider Active NPI

Jason Bruce Potes, D.O.

  • Emergency Medicine Physician
  • Columbia, SC
National Provider Identifier
1861404626
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
37619 Issued in SC
Practice address
14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896
Phone
(803) 434-1663
Fax
(803) 434-3894
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 37619 SC Primary

Addresses

Primary practice location

14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896

Mailing address

300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151022002122 SC Practitioner - Emergency Medicine 4082666516 Reassigns benefits to 3 organizations
I20231120002972 NC Practitioner - Emergency Medicine 4082666516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
New York College of Osteo Medicine of New York Institute of Technology, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians

Practice addresses (Care Compare)

14 Richland Medical Park Dr
Suite 350
Columbia, SC 29203-6896
Phone (803) 434-1663

222 S Herlong Ave
Rock Hill, SC 29732-1158
Phone (803) 329-1234

509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 213-1111

Hospital & facility affiliations

  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105
  • Prisma Health Tuomey Hospital Hospital, Sumter, SC, CCN 420070
  • Musc Medical Center Hospital, Charleston, SC, CCN 420004
  • McLeod Health Clarendon Hospital, Manning, SC, CCN 420109
  • Piedmont Medical Center Hospital, Rock Hill, SC, CCN 420002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Physician Assistant

State licenses

LicenseStateTypeSpecialty
37619SCMDEmergency Medicine Physician
008016NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Emergency Medicine CurrentSince Oct 22, 2023 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Aug 21, 2024 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Oct 22, 2023 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Prisma Health Tuomey CurrentSince Jan 19, 2016 Accepting new patients
Prisma Health Tuomey Emergency Medicine CurrentSince Jan 19, 2016 Accepting new patients
Emergency Medical of Sound Shore PC Emergency Medicine Past Accepting new patients
On Demand Urgent Care Group PC Past Accepting new patients
Montefiore Medical Center Emergency Medicine Past Accepting new patients
Healthmakers Medical Group, P.C. Past Accepting new patients

Locations

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

615 Ridge Rd
Roxboro, NC 27573
Phone (336) 503-5699

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

14 Richland Medical Park Dr
Ste 350
Columbia, SC 29203
Phone (803) 434-1663

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

222 Herlong Ave S
Rock Hill, SC 29732
Phone (803) 324-1950

129 N Washington St
Sumter, SC 29150
Phone (803) 774-1752

Interoperability endpoints

  • Direct secure messaging: jpotes423648@direct.ghs.myhfn.org

Organizations & group practices 11

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1861404626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 E MCBEE AVE FL 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296012842",
            "telephone_number": "864-522-8603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 RICHLAND MEDICAL PARK DR STE 350",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036896",
            "telephone_number": "803-434-1663",
            "fax_number": "803-434-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTES",
        "first_name": "JASON",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "37619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.