DR. KENT H POTTS (NPI# 1598752503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598752503 |
| Entity Type | Individual |
| Full Name | DR. KENT H POTTS |
| Practice Address |
2307 Gordon Cooper Dr Shawnee OK 74801-9007 |
| Mailing Address |
12905 Deerfield Ct Oklahoma City OK 73142-5138 |
| Practice Telephone | 4058784693 |
| Practice Fax Number | 4058784690 |
| Mailing Telephone | 4057520957 |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2008-07-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
8526 | OK | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | RAILROAD MEDICARE | 060051779 | 01 |
| OK | 100104450A | 05 |
| Street Address |
2307 GORDON COOPER DR |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74801-9007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619505179 | Kiley Nicole Henderson | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2020-03-31 |
| 1801422944 | Joni Pataki | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2020-03-20 |
| 1265063960 | Stephanie Alvillar | Nurse Practitioner | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2020-01-31 |
| 1629618640 | Savannah Nycole Bagwell | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2020-01-07 |
| 1770130379 | Darci Leigh Jenkins | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2019-08-20 |
| 1356997423 | Christina Marie Trout | Registered Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2019-08-14 |
| 1720630262 | Dayna Kathleen Grandstaff | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2019-07-15 |
| 1891251575 | Monica Jinkins | Licensed Practical Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2019-02-18 |
| 1700351392 | Shelby Janae Parsons | Registered Nurse | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2018-10-10 |
| 1669957734 | Regina Sioux Ertz | Psychologist | 2307 Gordon Cooper Dr, Shawnee, OK 74801-9007 | 2018-09-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538609037 | Melissa Lanier | Specialist | 801 N. Louisa, Shawnee, OK 74801 | 2017-03-02 |
| 1518365287 | Melanie A. Croy | Counselor | 1605 N. Harrison, Shawnee, OK 74801 | 2014-12-12 |
| 1134532229 | Megan Malouf | Registered Nurse | 2307 Gordon Cooper Dr., Shawnee, OK 74801 | 2014-06-05 |
| 1063836609 | Daniel Antwain Shaw | Counselor | 605 S. Pottenger Ave, Shawnee, OK 74801 | 2014-02-18 |
| 1639514862 | Cheryl Jeannette Left Hand | Counselor | 101 N. Union, Shawnee, OK 74801 | 2013-05-01 |
| 1881948644 | Lena I Samilton | Counselor | 319 S. Kennedy Ave., Apt.112, Shawnee, OK 74801 | 2012-11-01 |
| 1235433681 | Jenifer Sloan | Case Manager/Care Coordinator | 2029 S. Gordon Cooper Dr., Shawnee, OK 74801 | 2010-12-28 |
| 1295854958 | Jack C Luman | Dentist | 1410 N Harrison St, Shawnee, OK 74801 | 2007-03-27 |
| 1942375274 | M Gerald Ball | Psychologist | 819 North Kickapoo, Shawnee, OK 74801 | 2006-11-21 |
| 1205912573 | Regina Steciak Tanner | Physical Therapist | 909 N Kickapoo, Shawnee, OK 74801 | 2006-10-31 |
| Find all providers in zip 74801 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487600060 | Walid John Haddad | Internal Medicine | 3306 N Kickapoo Ave Ste 150, Shawnee, OK 74804-1718 | 2006-05-26 |
| 1437119286 | Sudhir K Gupta | Internal Medicine | 3208 Medical Park Drive, Shawnee, OK 74804-1707 | 2006-03-24 |
| 1780689844 | Troy R Norred | Internal Medicine | 3315 Kethley Rd, Shawnee, OK 74804 | 2005-06-16 |
| 1881945277 | Unity Physician Group | Internal Medicine | 1102 W Macarthur St, Shawnee, OK 74804-1743 | 2012-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730790148 | Epic Heart Health | Internal Medicine | 1211 N Shartel Ave Ste 1005, Oklahoma City, OK 73103-2433 | 2020-08-11 |
| 1801355813 | Tulsa Cardiovascular Center of Excellence, L.l.c | Internal Medicine | 11912 S Norwood Ave Ste 105, Tulsa, OK 74137-5509 | 2019-03-19 |
| 1316469109 | Razan Ali Mohamed Elsayed | Internal Medicine | 800 Stanton L Young Blvd # 5481, Oklahoma City, OK 73104-5018 | 2017-07-12 |
| 1184043556 | Heart & Vascular Specialist of Oklahoma Pllc | Internal Medicine | 15601 Kestral Park Ct, Edmond, OK 73013-9505 | 2014-04-14 |
| 1316283724 | Jean Ann Pitts | Internal Medicine | 11177 Ns 367 Rd, Okemah, OK 74859-4437 | 2012-12-13 |
| 1356621353 | Taraka Vijaya Rama Raju Gadiraju | Internal Medicine | 6151 S Yale Ave Ste 1-304, Tulsa, OK 74136-1907 | 2011-08-22 |
| 1760776694 | Biyebelemo A Ekpete | Internal Medicine | 2115 Duncan Regional Loop Ste 200, Duncan, OK 73533-1577 | 2011-06-08 |
| 1174750749 | Matthew Joseph Comstock | Internal Medicine | 11912 S Norwood Ave Ste 110, Tulsa, OK 74137-5509 | 2009-06-22 |
| 1841441151 | Mohamad A. Mahayni, M.d., Inc. | Internal Medicine | 3502 W Okmulgee St, Muskogee, OK 74401-5073 | 2008-10-06 |
| 1225201718 | Christian Cardiovascular Institute PC | Internal Medicine | 3300 Nw 56th Street, Suite 200, Oklahoma City, OK 73112-4401 | 2008-04-07 |
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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.