Michael Potts, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036068700 Issued in IL

Practice address

2780 McFarland Rd
Pediatrics
Rockford, IL 61107-6807

Phone

(815) 971-3070

Fax

(815) 637-0040

NPI assigned

Dec 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Rockford Health Physicians

  • Multi-Specialty Clinic/Center
  • Rockford, IL
  • NPI 1043242886
  Medicare reassignment NPD
• RMH Pathologists, LTD

  • Anatomic Pathology Physician
  • Rockford, IL
  • NPI 1184671992
  NPD

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1881679090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 MCFARLAND RD",
            "address_2": "PEDIATRICS",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076807",
            "telephone_number": "815-971-3070",
            "fax_number": "815-637-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 MCFARLAND RD",
            "address_2": "PEDIATRICS",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076807",
            "telephone_number": "815-971-3070",
            "fax_number": "815-637-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTS",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036068700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036068700",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036068700",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Charles Porter, M.D.
• Tajinee R Porter, PA-C
• Positive Reflections Adult Day Care LLC
• Thomas J Poswilko, OD
• Sara Marie Pottinger
• Michael Poulsen, PHARMD
• Christina R Powell, NP-C
• David Wayne Powell, AU.D.
• Lynne Susan Powell, M.D.
• James A Powers Jr., LCSW

• Pediatrics Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.