STEPHANIE KATHRYN POTTER


Address: 302 W Idaho St, Boise, ID 83702-6039
Phone: 2083694590

STEPHANIE KATHRYN POTTER (NPI# 1609892413) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609892413
Entity Type Individual
Full Name STEPHANIE KATHRYN POTTER
Credential M.D.
Practice Address 302 W Idaho St
Boise
ID 83702-6039
Mailing Address 200 Mullins Dr
Lebanon
OR 97355-3983
Practice Telephone 2083694590
Practice Fax Number 2089062346
Mailing Telephone 5412590200
Enumeration Date 2006-07-14
Last Update Date 2019-06-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine MD177584 OR Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine M-10113 ID Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine N-3251 TX Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine MR-0872 ID Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
ID MEDICARE RAILROAD P01009617 01
ID MEDICARE PTAN 1196215 01
ID 1609892413 05

Other Providers STEPHANIE POTTER

NPI Name Taxonomy Address Enumeration
1750846903 Stephanie Ann Potter Pharmacist 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 2019-02-01

Office Location

Street Address 302 W IDAHO ST
City BOISE
State ID
Zip Code 83702-6039

Providers in the same location

NPI Name Taxonomy Address Enumeration
1427443613 Sparkmd Clinic/Center 302 W Idaho St, Boise, ID 83702-6039 2015-04-03
1306057641 Brandon Micah Brevig Physical Medicine & Rehabilitation 302 W Idaho St, Boise, ID 83702-6039 2007-05-25

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790321966 Inland Northwest Neuromonitoring Pllc Psychiatry & Neurology 950 Bannock Street, Suite 1100, Boise, ID 83702 2019-11-22
1508359084 Emily Cook Dietitian, Registered St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 2018-06-11
1265925887 Marla Braendle Dietitian, Registered St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 2018-06-08
1114419678 Sidrah Khan Psychotherapy PC Social Worker 242 N 8th St, Suite 200, Boise, ID 83702 2018-05-31
1508386707 Emp Idaho Nampa, LLC General Acute Care Hospital 350 E Myrtle Street, Suite 100, Boise, ID 83702 2017-06-20
1194264077 Karen Mangum Dietitian, Registered 115 N. Main Street, Suite #203, Boise, ID 83702 2017-02-13
1750828422 Stephen Pyper Massage Therapist 14089 Main St #100, Boise, ID 83702 2017-01-19
1427504398 The Young Mens Christian Association of Boise City Idaho Health Educator 419 N 11th St, Boise, ID 83702 2016-08-30
1942756838 Brent Hiroshi Sasaki Pharmacist 500 West Fort Street (119), Boise, ID 83702 2016-08-30
1578912051 Marnae Walker Counselor 509 S. 14th St, Suite 2, Boise, ID 83702 2016-06-06
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1790269389 Erin Michelle Love Mcdermott Family Medicine 2402 W Jefferson St, Boise, ID 83702-4811 2018-09-19
1336656040 Functional Medicine of Idaho PC Family Medicine 3858 N Garden Center Way Ste 100, Boise, ID 83703-5008 2018-01-03
1922456870 Daniel Luftig Family Medicine 1041 S Dale St Apt 302, Boise, ID 83706-7641 2016-06-01
1942676598 Robert F. Smith, Md, Pllc Family Medicine 320 N Collins Rd, Boise, ID 83702-4519 2015-08-18
1861827222 Treasure Valley Neuropathy Relief Center PC Family Medicine 1755 N Westgate Dr, Suite 200, Boise, ID 83704-7174 2013-09-04
1205272986 Shahla Walizada Family Medicine 2141 E Parkcenter Blvd, Samg Bhp Family Medicine, Boise, ID 83706 2013-05-21
1891057246 Kara Mackenzie Kuntz Family Medicine 5966 W Curtisian Road, Boise, ID 83704 2012-06-12
1922366707 Cottonwood Family Medicine Family Medicine 100 Cottonwood Court, Suite 150, Boise, ID 87616 2012-04-30
1720377476 Steven Schneider Family Medicine 3775 W Quail Hollow Dr, Boise, ID 83703-3869 2011-04-04
1922311042 Amber Vania Family Medicine 4971 W. Overland Road, Boise, ID 83705 2010-07-18
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Competitor

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City BOISE
Zip Code 83702

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Dataset Information

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.

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