Potter Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

POTTER PHYSICAL THERAPY LLC

Practice address

5318 Van Dyke Rd
Lutz, FL 33558-4829

Phone

(813) 265-3033

Fax

(727) 362-7060

NPI assigned

Jul 14, 2021

Last updated

Nov 15, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adriana Nascimento Potter, PTNPI 1114185105

Title

Physical Therapist

Phone

(813) 265-3033

Specialties & licenses 1

Addresses

Other names 1

• Benefit Physical Therapy LLC Former legal business name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adriana Nascimento Potter, P.T.

  • Physical Therapist
  • Lutz, FL
  • NPI 1114185105
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1626220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1922670314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5318 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584829",
            "telephone_number": "813-265-3033",
            "fax_number": "813-727-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5318 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584829",
            "telephone_number": "813-265-3033",
            "fax_number": "727-362-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTER PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-14",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_middle_name": "NASCIMENTO",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "813-265-3033",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://app.consensus.com/account/dashboard",
            "affiliation": "N",
            "endpointDescription": "HIPPA compliant fax system",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF",
            "address_1": "5318 Van Dyke Rd",
            "city": "Lutz",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335584829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Benefit Physical Therapy LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Diana Marcela Ponce, APRN, FNP-BC
• Renea Marie Porsch, PT, DPT, ATC
• David K Porter, LMHC
• Walter Ivan Porto Gutierrez, MSW, LCSW
• Poornima Pothumarthi, PHARM D
• Adriana Nascimento Potter, P.T.
• Mariam Poules
• Kristina Powell-Samuel, LCSW
• Ashley N Powell
• Joyce Ann Prahasky, MASSAGE THERAPIST

• Physical Therapy Clinic/Center in Lutz, FL
• Providers in Lutz, FL by specialty
• Physical Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.