JORDAN RICHARD POTHAST (NPI# 1194125120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194125120 |
| Entity Type | Individual |
| Full Name | JORDAN RICHARD POTHAST |
| Credential | PA |
| Practice Address |
12200 Warwick Blvd Suite 310 Newport News VA 23601-2344 |
| Mailing Address |
856 J Clyde Morris Blvd Suite A Newport News VA 23601-1318 |
| Practice Telephone | 7575349988 |
| Practice Fax Number | 7575345688 |
| Mailing Telephone | 7575944006 |
| Mailing Fax Number | 7575345190 |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0110004696 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
12200 WARWICK BLVD SUITE 310 |
| City | NEWPORT NEWS |
| State | VA |
| Zip Code | 23601-2344 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982601993 | Eric A Weiner | Internal Medicine | 12200 Warwick Blvd, Ste 290, Newport News, VA 23601-2548 | 2005-07-05 |
| 1477078541 | Nicole Cara Otten | Physician Assistant | 12200 Warwick Blvd, Newport News, VA 23601-2344 | 2017-08-09 |
| 1154860484 | Sandy N Bacallao | Nurse Practitioner | 12200 Warwick Blvd, Suite 310, Newport News, VA 23601-2344 | 2017-02-20 |
| 1669915716 | Alana Hutchens | Physician Assistant | 12200 Warwick Blvd, Suite 310, Newport News, VA 23601-2344 | 2016-11-22 |
| 1255881470 | Juliane Davis-lowther | Nurse Practitioner | 12200 Warwick Blvd, Suite 290, Newport News, VA 23601-2344 | 2016-10-12 |
| 1386193100 | Crystal Fesperman | Physician Assistant | 12200 Warwick Blvd, Suite 310, Newport News, VA 23601-2344 | 2016-09-22 |
| 1558781807 | Brian Andrew Holloway | Dermatology | 12200 Warwick Blvd, Suite 490a, Newport News, VA 23601-2344 | 2014-04-24 |
| 1346660982 | Amy Schendel | Orthopaedic Surgery | 12200 Warwick Blvd, Suite 480, Newport News, VA 23601-2344 | 2014-04-22 |
| 1881027209 | Riverside Physcian Services Inc | Internal Medicine | 12200 Warwick Blvd, Suite 310, Newport News, VA 23601-2344 | 2013-08-21 |
| 1386908358 | John Russell Barley Iv | Family Medicine | 12200 Warwick Blvd, Suite 310, Newport News, VA 23601-2344 | 2012-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740809235 | Joshua Alan Albert | Student in an Organized Health Care Education/Training Program | Riverside Family Medicine Center 10510 Jefferson Ave, Suite A, Newport News, VA 23601 | 2020-04-14 |
| 1053959957 | Sisters In Homecare LLC | Home Health | 716 J Clyde Morris Blvd, Newport News, VA 23601 | 2019-12-11 |
| 1811450638 | Kevin Lavender | Student in an Organized Health Care Education/Training Program | Riverside Brentwood Medical Center, 10510 Jefferson Avenue Suite A, Newport News, VA 23601 | 2019-04-09 |
| 1578025532 | Cortlandt Mercy Sellers | Student in an Organized Health Care Education/Training Program | Riverside Regional Medical Center, 500 J Clyde Morris Blvd, 2 Annex, Newport News, VA 23601 | 2019-04-01 |
| 1407352974 | Stephen Leinfelder | Student in an Organized Health Care Education/Training Program | 500 J. Clyde Morris Blvd., Dept. of Medical Education, Second Floor Annex, Newport News, VA 23601 | 2018-04-03 |
| 1104359132 | Nicholas Alexander Austin | Student in an Organized Health Care Education/Training Program | 500 J. Clyde Morris Blvd., Second Floor Annex, Riverside Transitional Internship Program, Newport News, VA 23601 | 2017-04-06 |
| 1609312883 | Bright Nii Lante Lamptey | Pharmacist | 600 J Clyde and Morris Blvd, Newport News, VA 23601 | 2017-01-12 |
| 1417490517 | Justin Chamblee | Pharmacist | 671 J. Clyde Morris Blvd, Newport News, VA 23601 | 2016-11-22 |
| 1447706080 | Megan Elizabeth Cobb | Physician Assistant | 500 J Clyde Morrisl Blvd, Suite 603, Newport News, VA 23601 | 2016-09-01 |
| 1669815957 | Christina Michelle Wray Mcmillan | Nurse Practitioner | 416 J. Clyde Morris Blvd., Newport News, VA 23601 | 2013-04-17 |
| Find all providers in zip 23601 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639786320 | William Barr | Physician Assistant | 240 Gena Ct, Newport News, VA 23602-6300 | 2020-09-26 |
| 1407327737 | Caroline Suttle | Physician Assistant | 44 Barclay Rd, Newport News, VA 23606-1465 | 2018-12-16 |
| 1447706080 | Megan Elizabeth Cobb | Physician Assistant | 500 J Clyde Morrisl Blvd, Suite 603, Newport News, VA 23601 | 2016-09-01 |
| 1922554112 | Benjamin Timothy Housley | Physician Assistant | 12715 Warwick Blvd Ste O, Commonwealth Family Practice, Newport News, VA 23606-1800 | 2016-08-29 |
| 1679802938 | Taiwo Adeogun | Physician Assistant | 594 Hollins Ct, #105, Newport News, VA 23608-1755 | 2009-12-16 |
| 1275760035 | Ryan Julia Sykes | Physician Assistant | 11828 Canon Blvd Ste E, Newport News, VA 23606-2554 | 2009-06-18 |
| 1992961361 | Tonia Yocum | Physician Assistant | 751 J. Clyde Morris Blvd, Newport News, VA 23601 | 2008-08-05 |
| 1194813048 | Suzanne Fahy Miller | Physician Assistant | 1051 Loftis Blvd Ste 100, Newport News, VA 23606 | 2006-10-10 |
| 1043234818 | Jennifer Morrison | Physician Assistant | 11713 Jefferson Ave, Suite 200, Newport News, VA 23606-2400 | 2006-07-26 |
| 1588625610 | Craig Leslie Knott | Physician Assistant | 116 Lake Pointe Dr, Newport News, VA 23603-1375 | 2006-03-29 |
| Find all providers in NEWPORT NEWS | ||||
| City | NEWPORT NEWS |
| Zip Code | 23601 |
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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.