Active NPI
Jaime Potter, MS, AT
- Athletic Trainer
- Fullerton, CA
National Provider Identifier
1982130415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 800 N State College Blvd
Fullerton, CA 92831-3547 - Phone
- (657) 278-4987
- NPI assigned
- May 3, 2017
- Last updated
- May 3, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | NU | Primary |
Addresses
Primary practice location
800 N State College Blvd
Fullerton, CA 92831-3547
Mailing address
4020 E 15TH St
Long Beach, CA 90804-3032
Phone (937) 272-6567
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493769600000",
"number": "1982130415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4020 E 15TH ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908043032",
"telephone_number": "937-272-6567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 N STATE COLLEGE BLVD",
"city": "FULLERTON",
"state": "CA",
"postal_code": "928313547",
"telephone_number": "657-278-4987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "JAIME",
"credential": "MS, AT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-03",
"last_updated": "2017-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fullerton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.