JEFFREY D POTERACKI (NPI# 1679090922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679090922 |
| Entity Type | Individual |
| Full Name | JEFFREY D POTERACKI |
| Practice Address |
400 Union Hill Dr Ste 100 Birmingham AL 35209-2064 |
| Practice Telephone | (205) 812-4331 |
| Mailing Telephone | 2058124331 |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2017-08-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246ZE0600X |
Specialist/Technologist, Other Specialization: Electroneurodiagnostic |
Technologists, Technicians & Other Technical Service Providers |
| Street Address |
400 UNION HILL DR STE 100 |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35209-2064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437793510 | Marissa M Mcintyre | Registered Nurse | 3401 Independence Drive, Suite 221, Birmingham, AL 35209 | 2019-11-01 |
| 1093284457 | Patriot Healthcare of Alabama, LLC | Family Medicine | 2045 Brookwood Medical Center Drive, Suite 1, Birmingham, AL 35209 | 2018-11-15 |
| 1164902268 | Lucy Johnston | Physician Assistant | 1602 Woodfern Dr, Homewood, AL 35209 | 2018-08-17 |
| 1881184646 | Wade Louis Grady | Specialist/Technologist | 800 Larkshore Drive, Birmingham, AL 35209 | 2018-05-16 |
| 1154823029 | Taylor Payne | Physical Medicine & Rehabilitation | 109 Devon Dr, Birmingham, AL 35209 | 2018-03-06 |
| 1396251542 | 1st America Infusion Services LLC | Durable Medical Equipment & Medical Supplies | 120 Oxmoor Blvd Ste 100, Birmingham, AL 35209 | 2017-12-26 |
| 1376060954 | Hannah Holloway | Specialist/Technologist | 725 Crest Lane, Birmingham, AL 35209 | 2017-08-24 |
| 1558887463 | Paul A Rhodes | Nurse Practitioner | 631 Beacon Center Office Park, Suite 108, Birmingham, AL 35209 | 2017-08-22 |
| 1538542196 | Proteus Molecular and Clinical Lab LLC | Clinical Medical Laboratory | 218 Summit Pkwy, Suite 250, Homewood, AL 35209 | 2015-07-01 |
| 1124407739 | Randall Alban | Nurse Practitioner | 2100 Southbridge Parkway, Suite 650, Birmingham, AL 35209 | 2015-05-28 |
| Find all providers in zip 35209 | ||||
| Taxonomy Code | 246ZE0600X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Electroneurodiagnostic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821548041 | Megan Thomas | Specialist/Technologist, Other | 200 Union Hill Dr, Ste. 301, Birmingham, AL 35209-2067 | 2016-10-12 |
| 1285184994 | Thomas Williams | Specialist/Technologist, Other | 305 Leach Dr, Birmingham, AL 35213-2709 | 2016-10-05 |
| 1376992461 | Neurosafe, LLC | Specialist/Technologist, Other | 400 Union Hill Dr, Suite 100, Birmingham, AL 35209-2023 | 2016-06-08 |
| 1740734037 | Neurosafe of Alabama, LLC | Specialist/Technologist, Other | 400 Union Hill Dr, Suite 100, Birmingham, AL 35209-2023 | 2016-08-04 |
| City | BIRMINGHAM |
| Zip Code | 35209 |
Please comment or provide details below to improve the information on JEFFREY D POTERACKI.
| 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.