DR. DANITA RENAE POTTER (NPI# 1073167573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073167573 |
| Entity Type | Individual |
| Full Name | DR. DANITA RENAE POTTER |
| Credential | PMHNP |
| Practice Address |
518 Durham St Bastrop LA 71220-5013 |
| Mailing Address |
Po Box 792 Bastrop LA 71221-0792 |
| Practice Telephone | 3182838887 |
| Practice Fax Number | 3182812559 |
| Mailing Telephone | 3182838887 |
| Mailing Fax Number | 3182812559 |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2020-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
206980 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
518 DURHAM ST |
| City | BASTROP |
| State | LA |
| Zip Code | 71220-5013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083653620 | Shahzad M. Malik | Pediatrics | 518 Durham St, Bastrop, LA 71220-5013 | 2006-06-06 |
| 1770065799 | Brenton Lee Albritton | Nurse Practitioner | 518 Durham St, Bastrop, LA 71220-5013 | 2018-09-06 |
| 1144728494 | Elizabeth Hoskins | Nurse Practitioner | 518 Durham St, Bastrop, LA 71220-5013 | 2018-01-31 |
| 1801275573 | Mary Webster Rachal | Dentist | 518 Durham St, Bastrop, LA 71220-5013 | 2015-05-27 |
| 1447508817 | Jason Ryan Hoskins | Nurse Practitioner | 518 Durham St, Bastrop, LA 71220-5013 | 2012-08-16 |
| 1881957454 | Morehouse Community Medical Centers, Inc | Clinic/Center | 518 Durham St, Bastrop, LA 71220-5013 | 2012-06-19 |
| 1558508465 | Rose-marie Baker | Social Worker | 518 Durham St, Bastrop, LA 71220-5013 | 2009-01-14 |
| 1548327372 | Mamdouh Girgis Mickail | Family Medicine | 518 Durham St, Bastrop, LA 71220-5013 | 2007-01-02 |
| 1992877138 | Teresa Anderson Wood | Nurse Practitioner | 518 Durham St, Bastrop, LA 71220 | 2006-11-14 |
| 1457462491 | James Stephen Boyte | Nurse Practitioner | 518 Durham St, Bastrop, LA 71220-5013 | 2006-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952935983 | Broken Wings Recovery Center, LLC | Substance Abuse Rehabilitation Facility | 2869 New Monroe Road, Bastrop, LA 71220 | 2020-02-28 |
| 1275002685 | Hulin Urgent Care Services, LLC | Clinic/Center | 2100 East Madison Avenue, Bastrop, LA 71220 | 2018-11-14 |
| 1023594975 | Shuntel Ramona Johnson | Counselor | 8891 Holley Farm Road, Bastrop, LA 71220 | 2018-07-13 |
| 1376050526 | Kevin Hubbard | Case Manager/Care Coordinator | 9409 Willow Dr, Bastrop, LA 71220 | 2018-01-09 |
| 1265957229 | Alma Holmes | Behavioral Analyst | 644 E. Jefferson Ave, Bastrop, LA 71220 | 2017-08-10 |
| 1427570886 | Jennifer Rochelle Glosson | Counselor | 410 S. Franklin St, Bastrop, LA 71220 | 2017-07-07 |
| 1386179307 | Total Divine Care LLC | Community/Behavioral Health | 1840 North Washington Street, Bastrop, LA 71220 | 2017-04-27 |
| 1538609524 | Tyrra Watkins | Counselor | 10599 Parkwood Dr, Bastrop, LA 71220 | 2017-02-24 |
| 1528502119 | Oatie Brooks | Counselor | 813 Mccreight Street, Bastrop, LA 71220 | 2016-12-15 |
| 1487197810 | Valencia Reese | Counselor | 10434 Boswell St, Bastrop, LA 71220 | 2016-12-03 |
| Find all providers in zip 71220 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699386516 | Lindsey Sansing | Nurse Practitioner | 115 Mokolea Ln, Bastrop, TX 78602-7104 | 2020-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972113124 | Rebirth Mental Health Services LLC | Nurse Practitioner | 2116 Gause Blvd W Ste E, Slidell, LA 70460-4120 | 2020-08-03 |
| 1427668748 | Julie Susann Dyrek | Nurse Practitioner | 1 Lakeshore Dr Ste 1830, Lake Charles, LA 70629-0114 | 2020-08-01 |
| 1376169979 | Nancy Ariwodo | Nurse Practitioner | 225 Rue La France, Lafayette, LA 70508-1565 | 2020-06-19 |
| 1578183208 | Donald Glyn Gardner II | Nurse Practitioner | 324 Blue Fox Cir, Haughton, LA 71037-7707 | 2020-04-22 |
| 1629604129 | Raelyn Marie Plauche | Nurse Practitioner | 1951 Florida Ave Sw Ste D&e, Denham Springs, LA 70726-4947 | 2020-03-16 |
| 1962035964 | Tyler Trenton Wansley | Nurse Practitioner | 23515 Us-190, Mandeville, LA 70448 | 2020-02-18 |
| 1114558715 | Danielle J Threatts Aprn LLC | Nurse Practitioner | 208 W Gloria Switch Rd Ste 219, Lafayette, LA 70507-3409 | 2020-02-01 |
| 1992359848 | Harold G Frizzell Psychiatric Services LLC | Nurse Practitioner | 300 Thompson Loop, Lafayette, LA 70506-2820 | 2019-07-29 |
| 1598227779 | Candyce Brown | Nurse Practitioner | 333 Dr Michael Debakey Dr Ste 220, Lake Charles, LA 70601-5888 | 2019-04-04 |
| 1659835346 | Cassandra Thomas-jingles Psychiatric Nurse Practitioner, LLC. | Nurse Practitioner | 156 Mcgehee Dr, Baton Rouge, LA 70815-5012 | 2019-01-26 |
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| 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.