Active NPI
Kelly Ann Fischer Potts, PH.D.
- Psychologist
- Papillion, NE
National Provider Identifier
1992882229
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 607
- Practice address
- 535 Fortune Dr Ste 150
Papillion, NE 68046-3428 - Phone
- (402) 499-4108
- NPI assigned
- Nov 1, 2006
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 607 | NE | Primary |
Addresses
Primary practice location
535 Fortune Dr Ste 150
Papillion, NE 68046-3428
Mailing address
7700 SW 17TH St.
Lincoln, NE 68523-9200
Phone (402) 499-4108
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025483900 | Medicaid | NE |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 607 | NE | MD | Aerospace Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218412800000",
"number": "1992882229",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7700 SW 17TH ST.",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685239200",
"telephone_number": "402-499-4108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 FORTUNE DR STE 150",
"city": "PAPILLION",
"state": "NE",
"postal_code": "680463428",
"telephone_number": "402-499-4108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISCHER POTTS",
"first_name": "KELLY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2008-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NE",
"license": "607",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025483900",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Papillion, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.