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DR. DARRELL JACK POTTER M.D. NPI 1265412605


NPI Information

NPI: 1265412605
Provider Name: DR. DARRELL JACK POTTER, M.D.
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
5491 W ROSEBUD CT SE
#4
KENTWOOD, MI
ZIP 49512
Phone: (334) 322-3489
Get Directions

DR. Darrell Jack Potter, M.D. is an orthopaedic surgery in Kentwood, MI. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. DR. Darrell Jack Potter, M.D. NPI is 1265412605. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5491 W ROSEBUD CT SE
#4
KENTWOOD, MI
ZIP 49512-464
Phone: (334) 322-3489

The NPI 1265412605 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/20/2006 and was last updated on 11/3/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207X00000XOrthopaedic Surgery2006-01651NORTH CAROLINANo
2207X00000XOrthopaedic SurgeryMD-42830IOWANo
3207X00000XOrthopaedic Surgery2016005465MISSOURINo
4207X00000XOrthopaedic Surgery4301030727MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
141005MEDICAIDALABAMA
251041005OTHERALABAMABCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.