CLINTON J POTTER MD PA (NPI# 1407394109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407394109 |
| Entity Type | Organization |
| Organization Name | CLINTON J POTTER MD PA |
| Other Organization Name | ADVANCED INDIVIDUALIZED MEDICINE OF NAPLES |
| Practice Address |
720 Goodlette Rd N Ste. 204 Naples FL 34102-5656 |
| Mailing Address |
3180 Seasons Way Unit 901 Estero FL 33928-2375 |
| Practice Telephone | 2392603880 |
| Practice Fax Number | 2392603881 |
| Mailing Telephone | 4153777905 |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2017-02-02 |
| Authorized Official Name | DR. CLINTON J. POTTER (PRESIDENT/SECRETARY) |
| Authorized Official Telephone | 4153777905 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
ME 103986 | FL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Advanced Individualized Medicine of Naples | Doing Business As Name - Organization |
| Street Address |
720 GOODLETTE RD N STE. 204 |
| City | NAPLES |
| State | FL |
| Zip Code | 34102-5656 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285636233 | David B Rawlings | Clinical Neuropsychologist | 720 Goodlette Rd N, Ste 201, Naples, FL 34102-5656 | 2005-06-02 |
| 1801379961 | Advanced Direct Primary Care | Non-Pharmacy Dispensing Site | 720 Goodlette Rd N, Naples, FL 34102-5656 | 2018-09-13 |
| 1639566201 | Sheri Mangueira | Nurse Practitioner | 720 Goodlette Rd N, Suite 500, Naples, FL 34102-5656 | 2015-04-22 |
| 1760728554 | Cindy L. Brown | Clinical Nurse Specialist | 720 Goodlette Rd N, Suite 500, Naples, FL 34102-5656 | 2012-12-24 |
| 1164704649 | Advance Medical of Naples LLC | Clinic/Center | 720 Goodlette Rd N, Suite 300, Naples, FL 34102-5656 | 2011-09-12 |
| 1134412828 | Mary C. Coriano Pa | Social Worker | 720 Goodlette Rd N, Naples, FL 34102-5656 | 2011-05-27 |
| 1538463971 | Jill Marie Anderson | Nurse Practitioner | 720 Goodlette Rd N, Suite 500, Naples, FL 34102-5656 | 2010-12-28 |
| 1033370952 | J Daniel Labs Md Pa | Plastic Surgery | 720 Goodlette Rd N, Suite 205, Naples, FL 34102-5656 | 2008-06-23 |
| 1063625390 | Judith Ann Graser | Psychologist | 720 Goodlette Rd N, Naples, FL 34102-5656 | 2007-05-07 |
| 1285667907 | William D. Ertag, Md P.a. | Psychiatry & Neurology | 720 Goodlette Rd N, Suite 204, Naples, FL 34102-5656 | 2006-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710482948 | Aktive Motion Physical Therapy Inc | Clinic/Center | 1250 9th St N Ste 204, Naples, FL 34102 | 2018-03-28 |
| 1912428632 | Daily Care At Home, LLC | Home Health | 180 9th Street South, Suite 200, Naples, FL 34102 | 2017-07-03 |
| 1760737365 | Family Private Care Inc | Home Health | 1008 Goodlette Frank Rd N, Ste 201, Naples, FL 34102 | 2012-07-19 |
| 1013205384 | Valerie Jean Bress | Nurse Practitioner | 350 7th Street, Naples Community Hospital, Naples, FL 34102 | 2011-07-20 |
| 1154573830 | Gustavo D Rivera | Internal Medicine | 1064 Goodlette Road, Naples, FL 34102 | 2008-10-14 |
| 1881872281 | Proscan Imaging Naples, LLC | Radiology | 260 Tamiami Trail N, Naples, FL 34102 | 2008-02-07 |
| 1053595017 | Marlene Ann Diaczynsky | Registered Nurse | 350 7th Street North, Naples Community Hospital, Naples, FL 34102 | 2007-12-26 |
| 1699958330 | Georgiena Cobb | Counselor | 501 Goodlette Rd, Naples, FL 34102 | 2007-12-17 |
| 1124210158 | Maranatha Home Care, Inc. | Registered Nurse | 1164 Goodlette Road, Naples, FL 34102 | 2007-08-14 |
| 1669678645 | Naples Family Dentistry Inc | Dentist | 2176 Tamiami Trail North, Naples, FL 34102 | 2007-06-26 |
| Find all providers in zip 34102 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285193243 | Oasis Urgent Care, Pllc | Clinic/Center | 7385 Radio Rd Ste 104-d, Naples, FL 34104-6704 | 2019-03-18 |
| 1538401377 | Mycare Clinic | Clinic/Center | 6945 Carlisle Ct, Naples, FL 34109-6883 | 2013-03-19 |
| 1689975740 | Craig C. Davis, Md, Pl | Clinic/Center | 201 8th St S Ste 304, Naples, FL 34102-6117 | 2010-11-05 |
| 1689983389 | Edmund C Weidner Md Pa | Clinic/Center | 700 2nd Ave N Ste 205, Naples, FL 34102-5701 | 2010-09-29 |
| 1144837907 | True Health Medical and Wellness Center | Clinic/Center | 7955 Airport Pulling Rd N Ste 102, Naples, FL 34109-1794 | 2020-09-25 |
| 1215547310 | Prime Md of Naples | Clinic/Center | 2515 Northbrooke Plaza Dr Ste 200, Naples, FL 34119-8088 | 2020-08-04 |
| 1700376993 | Clinica Guadalupe, Corp. | Clinic/Center | 5475 Golden Gate Pkwy Ste 5w, Naples, FL 34116-7529 | 2018-05-14 |
| 1609312610 | Dr Erika Leigh Johnson Md | Clinic/Center | 12250 Tamiami Trl E, Suite 201, Naples, FL 34113-8108 | 2017-01-13 |
| 1437520350 | Angel's Medical Company | Clinic/Center | 5038 Coronado Pkwy, Naples, FL 34116-6950 | 2015-10-19 |
| 1275904823 | Midwest Concierge of Naples, LLC | Clinic/Center | 501 Goodlette Rd N Ste A103, Naples, FL 34102-5663 | 2015-10-08 |
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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.