KIMBERLY ANN POTTER (NPI# 1700378015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700378015 |
| Entity Type | Individual |
| Full Name | KIMBERLY ANN POTTER |
| Other Name | KIMBERLY ANN MCCORMICK |
| Practice Address |
3100 Apache Dr Jonesboro AR 72401-7404 |
| Practice Telephone | 8703335437 |
| Mailing Telephone | 8702153108 |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2018-06-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | 1164957080 | AR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790110096 | Kimberly Lynn Potter | Licensed Practical Nurse | 47 Darbyshire Dr, Jeffersonville, OH 43128-1104 | 2013-09-05 |
| 1396994042 | Kimberly Sue Potter | Registered Nurse | 4306 Southcross Dr, Batavia, OH 45103-7110 | 2008-09-17 |
| 1073147393 | Kimberly Elizabeth Potter | Nurse Practitioner | 4692 Brownsboro Rd, Winston Salem, NC 27106-3410 | 2020-02-25 |
| 1023457421 | Kimberly Potter | Nurse Practitioner | 3525 Olentangy River Rd, Ste,4330, Columbus, OH 43214-3937 | 2013-06-18 |
| 1205127370 | Kimberly A Potter | Behavioral Analyst | 294 Harrington Ave Ste 8, Closter, NJ 07624-1912 | 2011-04-25 |
| 1871809251 | Kimberly Potter | Social Worker | 1510 Waters Pl, Bronx, NY 10461-2700 | 2010-08-24 |
| 1609954676 | Kimberly Potter | Physical Therapist | 3009 New Bern Ave, Raleigh, NC 27610-1214 | 2006-11-01 |
| 1144311051 | Kimberly Potter | Physical Therapist | 540 Kingsley Ave, Orange Park, FL 32073-4847 | 2006-09-27 |
| Street Address |
3100 APACHE DR |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-7404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023074002 | Jeff Mullen | Radiology | 3100 Apache Dr, Suite C1, Jonesboro, AR 72401-7404 | 2006-04-26 |
| 1982170908 | Amanda Lashay Mathis | Licensed Practical Nurse | 3100 Apache Dr, Jonesboro, AR 72401-7404 | 2018-10-17 |
| 1811485295 | Shawna Mann | Licensed Practical Nurse | 3100 Apache Dr, Jonesboro, AR 72401-7404 | 2018-05-01 |
| 1164957080 | First Step Arkansas, LLC | Early Intervention Provider Agency | 3100 Apache Dr, Jonesboro, AR 72401-7404 | 2017-04-28 |
| 1518299577 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 3, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1881926848 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 1, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1326370388 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite A, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1972835924 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 4, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1245562206 | Northeast Arkansas Clinic Charitable Foundation, Inc | Durable Medical Equipment & Medical Supplies | 3100 Apache Dr, Suite B 2, Jonesboro, AR 72401-7404 | 2010-02-02 |
| 1790016418 | Northeast Arkansas Clinic Charitable Foundation, Inc | Clinic/Center | 3100 Apache Dr, Suite C1, Jonesboro, AR 72401-7404 | 2010-01-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316176878 | Specialty Pediatric and Autism Resource Clinic of Arkansas | Developmental Therapist | 1220 Stone St, Jonesboro, AR 72401-4519 | 2009-07-06 |
| 1881234565 | Tracie Fletcher | Developmental Therapist | 300 Southwest Sq, Jonesboro, AR 72401-5984 | 2020-01-10 |
| 1023260288 | Jennifer E Ray | Developmental Therapist | 3100 Apache Drive, Jonesboro, AR 72401 | 2008-10-21 |
| 1265658215 | Communication Made Easy Inc | Developmental Therapist | 151 Southwest Dr, Jonesboro, AR 72401-5828 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396379897 | Allison Nicole Davis | Developmental Therapist | 104 Hope St, Hoxie, AR 72433-9014 | 2020-02-24 |
| 1174161707 | Anna Shrum | Developmental Therapist | 721 Alford Street, Flippin, AR 72634 | 2019-12-13 |
| 1033752290 | Krista Crainer | Developmental Therapist | 4701 N Carbon City Rd, Ozark, AR 72949 | 2019-10-21 |
| 1063061216 | Dawn Renae Burnett | Developmental Therapist | 2001 E Kiehl Ave Ste 12, Sherwood, AR 72120-3123 | 2019-09-10 |
| 1972165827 | Heather Marie Box | Developmental Therapist | 344 Fayetteville Ave, Alma, AR 72921-3655 | 2019-07-01 |
| 1861954950 | Darnise Lashelle Price | Developmental Therapist | 18 Woodbriar Dr, Jacksonville, AR 72076-5365 | 2019-04-05 |
| 1164984373 | Keys (keeping Every Youth Safe) | Developmental Therapist | 2717 So Ringo Street, Little Rock, AR 72206-6554 | 2019-04-05 |
| 1194215350 | Amy Carol Yetley | Developmental Therapist | 8 Van Lee Dr, Little Rock, AR 72205-2452 | 2018-05-14 |
| 1447759782 | Lashauna Walton | Developmental Therapist | 129 Harvick Cir, Cabot, AR 72023-7107 | 2018-02-01 |
| 1780102210 | Janet Karen Watkins | Developmental Therapist | 1810 Ozarka College Drive, Mountain View, AR 72560 | 2017-09-05 |
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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.