MATTHEW EDWARDS POTTER (NPI# 1063971240) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063971240 |
| Entity Type | Individual |
| Full Name | MATTHEW EDWARDS POTTER |
| Practice Address |
475 W 940 N Provo UT 84604-3301 |
| Mailing Address |
2216 Sw Vermont St Portland OR 97219-9424 |
| Practice Telephone | 8013577940 |
| Mailing Telephone | 8186246613 |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2020-08-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 11839167-1204 | UT | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902427693 | Matthew Potter | Physical Therapist | 618 Marisol Dr, New Smyrna Beach, FL 32168-5356 | 2020-05-04 |
| 1285982686 | Matthew O'neil Potter | Rehabilitation Counselor | 1317 Sylvan Sand, Yukon, OK 73099-3161 | 2012-08-16 |
| 1548800378 | Matthew H Potter | Pharmacist | 7100 Broadway, Lemon Grove, CA 91945-1401 | 2020-01-09 |
| 1083145767 | Matthew Potter | Pharmacist | 3615 W Gandy Blvd, Tampa, FL 33611-2607 | 2017-03-23 |
| 1578004305 | Matthew G Potter | Nurse Practitioner | 911 Bypass Rd, Pikeville, KY 41501-1689 | 2017-03-13 |
| 1396011102 | Matthew Ross Potter | Internal Medicine | 3601 Tvc, Nashville, TN 37232-0001 | 2012-03-26 |
| 1427327980 | Matthew D Potter | Physician Assistant | 700 1st Ave S, Fargo, ND 58103-1802 | 2011-12-29 |
| 1881904266 | Matthew Allen Potter | Counselor | 15127 S 73rd Ave, Suite G, Orland Park, IL 60462-4398 | 2010-10-19 |
| 1205142817 | Matthew S Potter | Pharmacist | 87 E Williams Field Rd, Gilbert, AZ 85295-5202 | 2010-08-20 |
| Street Address |
475 W 940 N |
| City | PROVO |
| State | UT |
| Zip Code | 84604-3301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760598411 | Nicole Anne Clark | Family Medicine | 475 W 940 N, Provo, UT 84604-3301 | 2006-08-22 |
| 1093343980 | Matias A Calquin | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-28 |
| 1740817535 | Sean Alton Kiesel | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-24 |
| 1760019699 | Cameron G Smith | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-23 |
| 1578199592 | Jessica Fullmer | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-21 |
| 1285260232 | Tessa Nell | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-20 |
| 1154957207 | Andrew Reid Smith | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-20 |
| 1922634971 | Brady Monte Hansen | Student in an Organized Health Care Education/Training Program | 475 W 940 N, Provo, UT 84604-3301 | 2020-03-20 |
| 1952861288 | Daniel Payne | Family Medicine | 475 W 940 N, Provo, UT 84604-3301 | 2019-03-22 |
| 1548729734 | Brent Wells Lambson | Family Medicine | 475 W 940 N, Provo, UT 84604-3301 | 2019-03-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453160 | Utah Valley Natural Health Clinic | Family Medicine | 3311 N University Ave Ste 100, Provo, UT 84604-7432 | 2020-10-06 |
| 1750840054 | Jonathon Lee Gross | Family Medicine | 395 W Cougar Blvd Ste 205, Provo, UT 84604-3328 | 2019-03-16 |
| 1275099897 | Optimal Health Family Practice Pllc | Family Medicine | 75 S 200 E Ste 100, Provo, UT 84606-3146 | 2019-02-19 |
| 1518414481 | Ihc Health Services Inc | Family Medicine | 395 W Bulldog Blvd Ste 603, Provo, UT 84604 | 2016-09-08 |
| 1790175628 | Brigham Young University | Family Medicine | 173 Richards Building, Dance Department, Provo, UT 84602-2000 | 2015-01-30 |
| 1790198141 | Micia Roby | Family Medicine | 1055 N 500 W Building A, Provo, UT 84604 | 2014-06-03 |
| 1295171874 | Angel Kae Lybbert | Family Medicine | 395 W. Bulldog Blvd. Suite 6b, Provo, UT 84604 | 2013-05-22 |
| 1912267212 | Ihc Health Services Inc | Family Medicine | 1401 E 2000 S, Provo, UT 84606-2072 | 2012-05-21 |
| 1710250253 | Mark Timothy Ross | Family Medicine | 3737 N 970 E, Provo, UT 84604-5247 | 2012-02-14 |
| 1639497191 | John Frederic Templeman | Family Medicine | 4728 Mile High Dr, Provo, UT 84604-5318 | 2010-05-08 |
| Find all providers in PROVO | ||||
Please comment or provide details below to improve the information on MATTHEW EDWARDS POTTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.