DR. JEFFREY N POTTER (NPI# 1700861465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700861465 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY N POTTER |
| Credential | MD |
| Practice Address |
805 Hall St Wiggins MS 39577-2110 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6019284412 |
| Practice Fax Number | 6015795240 |
| Mailing Telephone | 6015795400 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 23577 | MS | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | MD024152E | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HIGHMARK BLUE SHIELD | 151890 | 01 | |
| CAP BLUE CROSS | 50000729 | 01 | |
| MS | 05706756 | 05 | |
| PA | 0008570430005 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124479019 | Jeffrey M Potter | Orthopaedic Surgery | 55 Fruit Street, Yawkey 3c, Massachusetts General Hospital, Boston, MA 02114 | 2016-06-22 |
| 1073649653 | Jeffrey D Potter | Radiology | 31 Bay Lawn Ave, Warwick, RI 02888-2952 | 2007-02-26 |
| 1154456531 | Jeffrey D. Potter | Dentist | 17300 Yorba Linda Blvd Ste D, Yorba Linda, CA 92886-3810 | 2007-02-23 |
| 1295994481 | Jeffrey A. Potter | Internal Medicine | 2730 University Blvd W, Suite 310, Wheaton, MD 20902-1905 | 2008-06-03 |
| 1114146990 | Jeffrey A. Potter | Pharmacist | 4087 Medina Rd, Suite 200, Medina, OH 44256-5946 | 2007-04-24 |
| 1831171222 | Jeffrey M Potter | Radiology | 2101 W Arlington Blvd Ste 210, Greenville, NC 27834-5758 | 2005-11-19 |
| Street Address |
805 HALL ST |
| City | WIGGINS |
| State | MS |
| Zip Code | 39577-2110 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063403491 | Calvin A Washington | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2005-11-03 |
| 1861888000 | Meagan Carney Taylor | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2015-04-14 |
| 1881845287 | Aesha Rahman | Internal Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2008-10-02 |
| 1558556621 | Ethan B Worthington | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2007-09-11 |
| 1437222015 | Tiffany Ll Worthington | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2006-11-15 |
| 1447350749 | Hattiesburg Clinic Pa | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2006-09-25 |
| 1932218302 | Catherine A Thompson | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2006-08-30 |
| 1669482824 | Constance M Goodyear | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2006-08-09 |
| 1114969656 | Marcus Donald Finch | Physician Assistant | 805 Hall St, Wiggins, MS 39577-2110 | 2006-06-11 |
| 1487631461 | Lisa D Morgan | Nurse Practitioner | 805 Hall St, Wiggins, MS 39577-2110 | 2005-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689057721 | John Thames | Emergency Medicine | 1428 Azalea Dr S, Wiggins, MS 39577 | 2015-07-07 |
| 1235468190 | Stone County School District | Local Education Agency (LEA) | 214 Critz Street, Wiggins, MS 39577 | 2009-12-23 |
| 1043452493 | Stone County Hospital, Inc | General Acute Care Hospital | 1434 E Central Ave., Wiggins, MS 39577 | 2009-04-01 |
| 1245274414 | James Walter Holmes | Family Medicine | 975 Hall Street, Wiggins, MS 39577 | 2006-06-16 |
| 1891223186 | Christine L Ladner | Nurse Practitioner | 1434 Central Ave E, Wiggins, MS 39577 | 2017-05-31 |
| 1790962637 | The Vision Center Pa | Optometrist | 1113 Central Ave E, Wiggins, MS 39577 | 2008-01-23 |
| 1821009465 | County Discount Drugs, Inc. | Durable Medical Equipment & Medical Supplies | 820 Hall St, Wiggins, MS 39577-2100 | 2006-08-10 |
| 1154430940 | Batson Physical Therapy, Inc. | Clinic/Center | 711 Hall St, Wiggins, MS 39577-2105 | 2006-08-29 |
| 1033723937 | Katherine B Tyree | Physical Therapist | 711 Hall St, Wiggins, MS 39577-2105 | 2020-09-08 |
| 1114569340 | Johelen K Trisler | Physical Therapy Assistant | 711 Hall St, Wiggins, MS 39577-2105 | 2019-10-09 |
| Find all providers in zip 39577 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245274414 | James Walter Holmes | Family Medicine | 975 Hall Street, Wiggins, MS 39577 | 2006-06-16 |
| 1518906734 | Donald Robert Doran Jr. | Family Medicine | 975 Hall St, Wiggins, MS 39577-2107 | 2006-06-05 |
| 1063403491 | Calvin A Washington | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2005-11-03 |
| 1104477710 | Memorial Hospital At Gulfport | Family Medicine | 1440 Central Ave E, Wiggins, MS 39577-9602 | 2019-09-25 |
| 1861888000 | Meagan Carney Taylor | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2015-04-14 |
| 1558556621 | Ethan B Worthington | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2007-09-11 |
| 1437222015 | Tiffany Ll Worthington | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2006-11-15 |
| 1447350749 | Hattiesburg Clinic Pa | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2006-09-25 |
| 1932218302 | Catherine A Thompson | Family Medicine | 805 Hall St, Wiggins, MS 39577-2110 | 2006-08-30 |
| 1265540603 | Robert K Partrige | Family Medicine | 1440 Central Ave E, Wiggins, MS 39577-9602 | 2006-08-27 |
| Find all providers in WIGGINS | ||||
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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.