CHARLES F POTTER (NPI# 1023092897) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023092897 |
| Entity Type | Individual |
| Full Name | CHARLES F POTTER |
| Credential | M.D. |
| Practice Address |
415 N 9th St Springfield IL 62702-5317 |
| Mailing Address |
129 W Miller Dr Mequon WI 53092-6189 |
| Practice Telephone | 2175446464 |
| Practice Fax Number | 2177576844 |
| Mailing Telephone | 2628258984 |
| Mailing Fax Number | 2624477330 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2019-09-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
036-112376 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036112376 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265888259 | Charles Potter | Counselor | 1251 Nilles Rd Ste 5, Fairfield, OH 45014-7205 | 2016-05-09 |
| 1487705125 | Charles Henry Potter | Emergency Medicine | 801 East Williams Avenue, Fallon, NV 89406 | 2007-01-16 |
| 1982789418 | Charles Alan Potter | Family Medicine | 1195 E Arques Ave, Suite 1, Sunnyvale, CA 94085-3904 | 2006-10-25 |
| 1396839890 | Charles R. Potter | Otolaryngology | 770 W High St, Suite 460, Lima, OH 45801-3990 | 2006-10-02 |
| 1275641409 | Charles A Potter | Dentist | 319 Center St, Dupont, PA 18641-1403 | 2006-08-28 |
| Street Address |
415 N 9TH ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-5317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235128109 | Krishna A Rao | Internal Medicine | 415 N 9th St, Springfield, IL 62702-5317 | 2005-10-13 |
| 1821611526 | Michelle Eide | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2020-05-28 |
| 1275156325 | Sivani Aluru | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2020-05-23 |
| 1316560626 | Jaycee Elizabeth Housh | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2020-05-20 |
| 1043832371 | Kerrilyn Hewell | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2020-05-08 |
| 1386205318 | Aneesh Surya Chawla | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2019-06-20 |
| 1144889965 | Maggie Lynn Sevrin | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2019-06-06 |
| 1063070597 | Emma Victoria James | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2019-05-30 |
| 1083272520 | Haylee Elizabeth Elvendahl-rumley | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2019-05-30 |
| 1962996769 | Erika Alejandra Gonzalez Osorio | Obstetrics & Gynecology | 415 N 9th St, Springfield, IL 62702-5303 | 2018-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1255623997 | Venkata Sasidhar Majjiga | Pediatrics | 301 N 8th Street, Siu School of Medicine, Pediatrics, Room 3a169, Springfield, IL 62794 | 2011-05-13 |
| 1831212976 | Douglas Terry Leonard | Pediatrics | 3355 River Bend Dr., Suite 220, Springfield, OR 97477-8800 | 2007-04-06 |
| 1992878169 | Michael Adrian Colasurdo | Pediatrics | 3355 Riverbend Dr Ste 220, Springfield, OR 97477-8800 | 2006-11-16 |
| 1699861740 | Saumitra Biswas | Pediatrics | 3801 S. National Avenue, 7th Floor, Springfield, MO 65807-5210 | 2006-10-05 |
| 1437116050 | Ozark Neonatal Associates, Inc. | Pediatrics | 1235 E Cherokee Street, Springfield, MO 65804-2203 | 2006-04-27 |
| 1841835816 | Stephanie Ann Barthelette | Pediatrics | 759 Chestnut St, Springfield, MA 01107-1619 | 2019-11-13 |
| 1275045171 | Kelsey Southard | Pediatrics | 3801 S National Ave, Springfield, MO 65807-5210 | 2017-11-01 |
| 1841607389 | Zaineh Alja'nini | Pediatrics | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2014-07-16 |
| 1811242043 | Khushbu Shukla | Pediatrics | 3801 S National Ave, Springfield, MO 65807-5210 | 2012-07-13 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
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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.