Carol Gray Potter, OTR/L, BCG, CAPS

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

6281 Issued in CT

Practice address

21 Candlewood LN
Madison, CT 06443-1914

Phone

(425) 478-6098

Fax

(425) 977-7193

NPI assigned

May 24, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Burakovskiy DPM PC

  • Foot & Ankle Surgery Podiatrist
  • Kirkland, WA
  • NPI 1881777266
  NPD (past)
• On Site Dermatology of Washington PLLC

  • Dermatology Physician
  • Seattle, WA
  • NPI 1083135693
  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1952304875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 CANDLEWOOD LN",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064431914",
            "telephone_number": "425-478-6098",
            "fax_number": "425-977-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 CANDLEWOOD LN",
            "city": "MADISON",
            "state": "CT",
            "postal_code": "064431914",
            "telephone_number": "425-478-6098",
            "fax_number": "425-977-7193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "CAROL",
        "middle_name": "GRAY",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, BCG, CAPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "WA",
            "license": "1963",
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "CT",
            "license": "6281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0153392",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BS",
            "identifier": "0373PO",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7682305",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Physical Therapy and Wellness Treatment Center, LLC
• Physical Therapy Center of Madison
• Taylor Marie Pisano, LMFT
• Christina Marie Polk
• Positive Choices Therapy, LLC
• Premier Home Health Care Services, Inc
• Priority Health Services LLC
• Lauren Elaine Provini, MD
• Henry Puciato, RN, APRN
• Erin Puzycki, LCSW

• Gerontology Occupational Therapist in Madison, CT
• Providers in Madison, CT by specialty
• Gerontology Occupational Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.