DR. JACK BENSON POTTER (NPI# 1073666087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073666087 |
| Entity Type | Individual |
| Full Name | DR. JACK BENSON POTTER |
| Credential | MD |
| Practice Address |
960 Johnson Ferry Rd Ne Suite 410 Atlanta GA 30342-1631 |
| Practice Telephone | 4042563788 |
| Practice Fax Number | 4048479613 |
| Mailing Telephone | 4042563788 |
| Mailing Fax Number | 4048479613 |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0201X |
Internal Medicine Specialization: Allergy & Immunology |
29755 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194030346 | Jack R Potter | Pharmacist | 6951 Lee Hwy, Chattanooga, TN 37421-2447 | 2010-08-12 |
| Street Address |
960 JOHNSON FERRY RD NE SUITE 410 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30342-1631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033112198 | Alan I Segal | Audiologist | 960 Johnson Ferry Rd Ne, Ste 200, Atlanta, GA 30342-1631 | 2005-05-23 |
| 1245628957 | Maryann Reuben | Specialist/Technologist, Other | 960 Johnson Ferry Rd Ne, Suite 120, Atlanta, GA 30342 | 2015-01-05 |
| 1679917835 | Comprehensive Internal Medicine At Northside | Internal Medicine | 960 Johnson Ferry Rd Ne, Suite 543, Atlanta, GA 30342-1631 | 2013-04-18 |
| 1881957553 | Allison M Sugg | Physician Assistant | 960 Johnson Ferry Rd Ne, Suite 200, Atlanta, GA 30342-1631 | 2012-06-19 |
| 1922392190 | Center for Pediatric Wellness, P.C. | Pediatrics | 960 Johnson Ferry Rd Ne, Suite 315, Atlanta, GA 30342-1631 | 2011-06-06 |
| 1780910737 | Faraa Mobini | Physician Assistant | 960 Johnson Ferry Rd Ne, Suite 200, Atlanta, GA 30342-1631 | 2009-10-27 |
| 1376779322 | Village Podiatry Group, P.C. | Podiatrist | 960 Johnson Ferry Rd Ne, Suite 310, Atlanta, GA 30342-1631 | 2009-06-04 |
| 1255597282 | Plastic Surgery Institute of Atlanta, P.C. | Plastic Surgery | 960 Johnson Ferry Rd Ne, Suite 245, Atlanta, GA 30342-1631 | 2008-07-30 |
| 1912165382 | Mervyn B Forman Md, L.l.c | Internal Medicine | 960 Johnson Ferry Rd Ne, Ste 530, Atlanta, GA 30342-1631 | 2008-06-02 |
| 1275722811 | Raymond V. Caputo, M.d.,p.c. | Dermatology | 960 Johnson Ferry Rd Ne, Suite 226, Atlanta, GA 30342-1631 | 2007-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820614 | Nia Charnice Griffin | Nurse Practitioner | 5670 Peachtree Dunwoodyroad, Suite 900, Atlanta, GA 30342 | 2020-10-26 |
| 1255945184 | Jennifer Lynne Cole | Behavior Technician | 5555 Glenridge Con Suite 200, Atlanta, GA 30342 | 2020-09-08 |
| 1093336232 | Van Tran | Respiratory Therapist, Registered | 1000 Johnson Ferry Rd Ne, Atlanta, Ga 30342, Atlanta, GA 30342 | 2020-04-28 |
| 1356978340 | Twyla Douglas Jackson I | Clinical Nutrition, 1000 Johnson Ferry Rd Ne, Atlanta, GA 30342 | 2020-03-27 | |
| 1760013411 | Emily Hamm | Dietitian, Registered | 933 D Johnson Ferry Road, Suite 250, Atlanta, GA 30342 | 2020-01-31 |
| 1043855984 | Mackenzie Tucker Wayda | Registered Nurse | 1001 Johnson Ferry Rd. Ne, Atlanta, GA 30342 | 2019-11-14 |
| 1386288454 | Tiauna Lashun Cochman | Psychologist | 1307 Glenridge Dr, Sandy Springs, GA 30342 | 2019-11-01 |
| 1164074399 | Stephen J. White | Hearing Instrument Specialist | 5775 Peachtree Dunwoody Rd Suite 600 Fl. 6, Uhc Hearing, Atl., GA 30342 | 2019-07-09 |
| 1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
| 1760954705 | Mishele Walker LLC | Counselor | 555 Glenridge Connector, Suite 200, Sandy Springs, GA 30342 | 2018-12-31 |
| Find all providers in zip 30342 | ||||
| Taxonomy Code | 207RA0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Allergy & Immunology |
| An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669891636 | Kristine Vanijcharoenkarn | Internal Medicine | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2014-04-07 |
| 1780699421 | Nathan Segall, M.d., P.C. | Internal Medicine | 980 Johnson Ferry Rd Ne, Suite 1080, Atlanta, GA 30342-1626 | 2006-07-30 |
| 1144276486 | Henry Ming-yow Wu | Internal Medicine | 550 Peachtree St Ne, Tec Medical Office Tower, Atlanta, GA 30308-2212 | 2006-05-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932217189 | Breathe Better Allergy, Asthma, and Sinus P.C. | Internal Medicine | 950 South Enota Drive, A, Gainesville, GA 30501 | 2006-08-28 |
| 1619982444 | Nathan Segall | Internal Medicine | 175 Country Club Dr 100a, Stockbridge, GA 30281-7380 | 2006-07-30 |
| 1689614885 | Robert Martin Cohen | Internal Medicine | 2390 Wall St Se, Conyers, GA 30013-2186 | 2006-06-07 |
| 1295737328 | Melvin Lee Haysman | Internal Medicine | 5400 Waters Ave, Savannah, GA 31404-6234 | 2005-08-10 |
| 1831432863 | Charmi D Patel | Internal Medicine | 1360 Caduceus Way Ste 102, Watkinsville, GA 30677-7300 | 2013-03-27 |
| 1861448110 | Mokhtar Hacena | Internal Medicine | 2054 Watson Blvd, Warner Robins, GA 31093-3634 | 2006-05-26 |
| 1104828250 | Wasil Khan | Internal Medicine | 1326 Eisenhower Dr, Bldg 2, Savannah, GA 31406-3928 | 2005-08-10 |
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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.