DR. KEVIN WAYNE POTTER (NPI# 1831355643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831355643 |
| Entity Type | Individual |
| Full Name | DR. KEVIN WAYNE POTTER |
| Credential | D.O. |
| Practice Address |
7330 N 99th Ave Ste 325 Glendale AZ 85307-3022 |
| Mailing Address |
3815 E Bell Rd Ste 2200 Phoenix AZ 85032-2139 |
| Practice Telephone | 6022091474 |
| Practice Fax Number | 6022091475 |
| Mailing Telephone | 6026333848 |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2019-09-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 005313 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 445137 | 05 | |
| AZ | MEDICARE | Z199540 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891751582 | Kevin Clyde Potter | Dentist | 1804 Warden St, Eau Claire, WI 54703 | 2006-04-22 |
| 1881725349 | Kevin Potter | Case Manager/Care Coordinator | 1280 Main St, 3rd Floor, Buffalo, NY 14209-1912 | 2007-03-08 |
| Street Address |
7330 N 99TH AVE STE 325 |
| City | GLENDALE |
| State | AZ |
| Zip Code | 85307-3022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386693976 | Lance Winter | Orthopaedic Surgery | 7330 N 99th Ave Ste 325, Glendale, AZ 85307-3003 | 2006-05-09 |
| 1962952358 | Laura Pomeroy | Dietitian, Registered | 7330 N 99th Ave Ste 325, Glendale, AZ 85307-3022 | 2016-10-10 |
| 1013256338 | Kelly Lynn Rauch | Nurse Practitioner | 7330 N 99th Ave Ste 325, Glendale, AZ 85307-3022 | 2013-02-06 |
| 1174818173 | Ryan Allan Pinnell | Surgery | 7330 N 99th Ave Ste 325, Glendale, AZ 85307-3003 | 2011-06-17 |
| 1194961664 | Ruth Roberta Mangino | Nurse Practitioner | 7330 N 99th Ave Ste 325, Glendale, AZ 85307-3022 | 2009-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154635761 | Aeroptics LLC | Optometrist | 7071 N 138th Av, Bldg 1540, Glendale, AZ 85307 | 2010-08-06 |
| 1902894579 | Daniela Nicosia | Optometrist | 7071 N 138th Ave, Luke Afb, AZ 85307 | 2005-10-07 |
| 1144633157 | Sharan Kaur Knott | Pharmacist | 10945 W Vista Ln, Glendale, AZ 85307-1645 | 2014-06-06 |
| 1841813961 | Yoshica Mitchell | Behavior Technician | 12923 W Lawrence Ct, Glendale, AZ 85307-1900 | 2020-05-22 |
| 1700328556 | Tonya Brown | Social Worker | 12912 W Mclellan Rd, Glendale, AZ 85307-1917 | 2016-11-10 |
| 1447806997 | Tamarra Kalamchi | Dentist | 7071 N 138th Ave Bldg 1540, Glendale, AZ 85307-2006 | 2019-08-12 |
| 1043623648 | Dr Larsen Eye Care Inc | Optometrist | 7071 N 138th Ave # 1552, Luke Afb, AZ 85307-2006 | 2014-06-11 |
| 1619519840 | Platinum Venture Group LLC | Durable Medical Equipment & Medical Supplies | 7071 N 138th Ave Bldg 1540, Glendale, AZ 85307-2006 | 2019-10-09 |
| 1710255989 | Optical Center | Technician/Technologist | 7071 N 138th Ave, Glendale, AZ 85307-2006 | 2011-12-02 |
| 1386088128 | Clifton Jamar Premo | Respiratory Therapist, Registered | 13517 W Glendale Ave, Apt 1135, Glendale, AZ 85307-2010 | 2013-04-23 |
| Find all providers in zip 85307 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902444623 | Skilled Physicians Group | Surgery | 3747 Foothill Blvd # B140, Glendale, CA 91214-1700 | 2019-12-12 |
| 1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
| 1629488358 | Nina Behdin | Surgery | 1560 E Chevy Chase Dr Ste 430, Glendale, CA 91206 | 2014-05-02 |
| 1740594761 | Joseph Anthony Dipasquale | Surgery | 18028 N 55th Ave, Glendale, AZ 85308-1302 | 2010-08-02 |
| 1538391479 | Chaparral Surgical Specialists.ltd | Surgery | 4601 W Bryce Ln, Glendale, AZ 85301-1626 | 2009-08-11 |
| 1942437629 | Moshe Barnajian | Surgery | 222 W Eulalia St Ste 100a, Glendale, CA 91204-2850 | 2009-06-19 |
| 1164699906 | Karthik Raghavan | Surgery | 5700 W Olive Ave Ste 106, Glendale, AZ 85302-3147 | 2008-05-12 |
| 1326186636 | David G Davtyan Md Inc A Professional Medicalcorp | Surgery | 1141 N Brand Blvd Ste 300, Glendale, CA 91202-2578 | 2007-02-01 |
| 1619037405 | Wan-lin Horng | Surgery | 20325 N 51st Ave Ste 102, Glendale, AZ 85308-5665 | 2006-12-11 |
| 1972690899 | Med-pro Family Clinic, A Medical Corporation | Surgery | 221 E. Glenoaks Blvd., 130, Glendale, CA 91207 | 2006-10-10 |
| Find all providers in GLENDALE | ||||
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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.