Individual provider Active NPI

Tiffany Helyn Potter, FNP

  • Nurse Practitioner
  • Canadian, TX
National Provider Identifier
1962740985
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
625274 Issued in TX
Practice address
1010 S 4TH St
Canadian, TX 79014-3315
Phone
(806) 323-8882
Fax
(806) 323-6108
NPI assigned
Jan 25, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 625274 TX Primary

Addresses

Primary practice location

1010 S 4TH St
Canadian, TX 79014-3315

Mailing address

1010 S 4TH St
Canadian, TX 79014-3315
Phone (806) 323-8882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130404000215 TX Practitioner - Nurse Practitioner 6406091966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hemphill County Hospital District 12 clinicians

Practice addresses (Care Compare)

1010 S 4TH St
Canadian, TX 79014-3315
Phone (806) 323-8882

1020 S 4TH St
Canadian, TX 79014-3315
Phone (806) 323-6422

Hospital & facility affiliations

  • Hemphill County Hospital Hospital, Canadian, TX, CCN 671301
  • Parkview Hospital Hospital, Wheeler, TX, CCN 451334
  • Bsa Hospital Hospital, Amarillo, TX, CCN 450231

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hemphill County Hospital District CurrentSince Nov 10, 2017 Accepting new patients
Canadian Family Physicians, PLLC Current Accepting new patients
Hemphill County Hospital District CurrentSince Nov 10, 2017 Accepting new patients
Amarillo Medical Group LLC Past Accepting new patients
Hemphill County Hospital District Past Accepting new patients
High Plains Medical Group, LLC Past Accepting new patients

Locations

1020 S 4th St
Canadian, TX 79014
Phone (806) 323-6422

1010 S 4th St
Canadian, TX 79014
Phone (806) 323-8882

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AAIAAA

Organizations & group practices 12

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 3

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": "1359072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1962740985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 S 4TH ST",
            "city": "CANADIAN",
            "state": "TX",
            "postal_code": "790143315",
            "telephone_number": "806-323-8882",
            "fax_number": "806-323-6108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S 4TH ST",
            "city": "CANADIAN",
            "state": "TX",
            "postal_code": "790143315",
            "telephone_number": "806-323-8882",
            "fax_number": "806-323-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTTER",
        "first_name": "TIFFANY",
        "middle_name": "HELYN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-25",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "625274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canadian, TX

Sources for this page

Verify at the official NPI Registry.