STACEY BROOKE POTTER (NPI# 1033585773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033585773 |
| Entity Type | Individual |
| Full Name | STACEY BROOKE POTTER |
| Credential | PT, DPT |
| Practice Address |
13720 Midway Rd Ste 107 Dallas TX 75244-4313 |
| Practice Telephone | 2146461449 |
| Practice Fax Number | 2146998962 |
| Mailing Telephone | 2146461449 |
| Mailing Fax Number | 2146998962 |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2015-08-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
1264605 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1264605 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306110838 | Stacey L Potter | Specialist | 313 N Monterey Ave, Farmington, NM 87401-6957 | 2012-03-01 |
| Street Address |
13720 MIDWAY RD STE 107 |
| City | DALLAS |
| State | TX |
| Zip Code | 75244-4313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275791956 | Amy Saba Ornelas | Occupational Therapist | 13720 Midway Rd Ste 107, Dallas, TX 75244-4313 | 2008-05-29 |
| 1568080927 | Rebecka Marie Tobin | Physical Therapist | 13720 Midway Rd Ste 107, Dallas, TX 75244-4313 | 2020-07-10 |
| 1821637380 | Emily Cors | Speech-Language Pathologist | 13720 Midway Rd Ste 107, Dallas, TX 75244-4313 | 2020-01-02 |
| 1982240222 | Lori Nicole Hartgraves | Speech-Language Pathologist | 13720 Midway Rd Ste 107, Dallas, TX 75244-4313 | 2019-11-21 |
| 1932637857 | Dana Suzanne Harmon | Occupational Therapist | 13720 Midway Rd Ste 107, Dallas, TX 75244-4313 | 2017-05-24 |
| 1477908150 | Caroline Laymance | Speech-Language Pathologist | 13720 Midway Rd Ste 107, Dallas, TX 75244-4313 | 2016-04-29 |
| 1255717922 | Shara Rogers | Speech-Language Pathologist | 13720 Midway Rd Ste 107, Dallas, TX 75244-4313 | 2015-08-05 |
| 1629417266 | Lindsay Jantz | Occupational Therapist | 13720 Midway Rd Ste 107, Dallas, TX 75244-4313 | 2013-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316561194 | Kevin Goodnight | Behavioral Analyst | 4230 Sigma Road, Dallas, TX 75244 | 2020-06-08 |
| 1851941413 | Medi-wheels, LLC | Durable Medical Equipment & Medical Supplies | 5005 Lbj Freeway, Ste. 840, Dallas, TX 75244 | 2019-09-16 |
| 1972157436 | Samantha Lograsso | Nurse Practitioner | 4055 Valley View Ln Suite 400, Dallas, TX 75244 | 2019-08-01 |
| 1205313780 | Cherae Ashland Burton | Licensed Vocational Nurse | 4099 Mcewen Rd., Farmers Branch, TX 75244 | 2018-07-26 |
| 1700383197 | Melissa Fitts | Behavioral Analyst | 13604 Midway Rd. #180, Farmers Branch, TX 75244 | 2018-04-11 |
| 1932607983 | Vcphcs, Lp | Clinic/Center | 5001 Spring Valley Road, Suite 600 East, Dallas, TX 75244 | 2018-01-24 |
| 1518406636 | Gentech Laboratories LLC | Clinical Medical Laboratory | 4403 N. Beltwood Parkway, Suite 300, Dallas, TX 75244 | 2017-02-22 |
| 1881045680 | Innovative Lifeskills Training Center LLC | Preferred Provider Organization | 5001 Spring Valley, Towers East Ste 400, Dallas, TX 75244 | 2016-06-23 |
| 1376992792 | Lynnlie Tuschoff | Registered Nurse | 4099 Mcewen, Suite 250, Farmers Brach, TX 75244 | 2016-06-07 |
| 1609223072 | Debra Jules | Licensed Vocational Nurse | 4099 Mcewen Road, Dallas, TX 75244 | 2016-05-16 |
| Find all providers in zip 75244 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356889729 | Marie Mazzola Solomon | Physical Therapist | 7732 Worthing St, Dallas, TX 75252-6448 | 2017-02-06 |
| 1760751291 | Loving Leaps, Inc | Physical Therapist | 4830 Cedar Springs Rd Apt 34, Dallas, TX 75219-1365 | 2011-12-29 |
| 1659505865 | Kelly Burch Abrajano | Physical Therapist | 6301 Gaston Ave # 750, Dallas, TX 75214-3922 | 2009-05-04 |
| 1144488222 | Dallas Occupational Therapy Services for Kids, Pllc | Physical Therapist | 13720 Midway Rd, Suite 107, Dallas, TX 75244-4313 | 2008-05-27 |
| 1467571117 | Yeisha Celeste Culp | Physical Therapist | 2535 Lone Star Drive, Dallas, TX 75212 | 2007-03-27 |
| 1730796137 | Carissa Stoddard | Physical Therapist | 2222 Welborn St, Dallas, TX 75219-3924 | 2020-09-29 |
| 1821602236 | Emily Eveler | Physical Therapist | 2535 Lone Star Dr, Dallas, TX 75212-6313 | 2020-09-02 |
| 1023626892 | Kylie Mclaughlin | Physical Therapist | 12770 Coit Rd Ste 870, Dallas, TX 75251-1455 | 2020-07-17 |
| 1568080927 | Rebecka Marie Tobin | Physical Therapist | 13720 Midway Rd Ste 107, Dallas, TX 75244-4313 | 2020-07-10 |
| 1043841810 | Ricki Donnell Graham | Physical Therapist | 6301 Gaston Ave Ste 750, Dallas, TX 75214-6339 | 2020-01-30 |
| Find all providers in DALLAS | ||||
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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.