MR. BRENT POTTER (NPI# 1871706481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871706481 |
| Entity Type | Individual |
| Full Name | MR. BRENT POTTER |
| Practice Address |
4182 N Bank St Kingman AZ 86409-2715 |
| Mailing Address |
2865 Rawhide Dr Kingman AZ 86401-7819 |
| Practice Telephone | 9286929813 |
| Practice Fax Number | 9286921507 |
| Mailing Telephone | 9286929813 |
| Mailing Fax Number | 9286921507 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-07-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YS0200X |
Counselor Specialization: School |
AZ | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 961575 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174636500 | Brent C Potter | Counselor | 1101 W College Ave, Spokane, WA 99201-2010 | 2006-08-17 |
| Street Address |
4182 N BANK ST |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86409-2715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659696607 | Marilyn Joyce Jenkins | Licensed Practical Nurse | 4182 N Bank St, Kingman, AZ 86409-2715 | 2010-04-02 |
| 1841405180 | Anne Marie Bathauer | Counselor | 4182 N Bank St, Kingman, AZ 86409-2715 | 2007-05-11 |
| 1235343583 | Theresa Vila Grumbles | Counselor | 4182 N Bank St, Kingman, AZ 86409-2715 | 2007-05-09 |
| 1467665000 | James Gunton | Counselor | 4182 N Bank St, Kingman, AZ 86409-2715 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437695731 | Medical Laboratory Specialty, Inc | Clinical Medical Laboratory | 3636 St, Kingman, AZ 86409 | 2017-01-10 |
| 1003219007 | Premier Home Health Agency | Home Health | 3555 Western Ave, Kingman, AZ 86409 | 2014-10-03 |
| 1558774984 | Fernando Velez | Pharmacist | 2003 Roy Rogers Way, Kingman, AZ 86409 | 2014-06-03 |
| 1013227834 | Route 66 Cab Inc | Taxi | 3595 E Us Highway 66, Kingman, AZ 86409 | 2010-10-14 |
| 1740503374 | Route 66 Cab Inc. | Taxi | 3595 East Hwy 66, Kingman, AZ 86409 | 2010-03-10 |
| 1649409145 | Arizona Cvs Stores, L.L.C. | Durable Medical Equipment & Medical Supplies | 3501 Stockton Hill Rd, Kingman, AZ 86409 | 2009-07-07 |
| 1790922896 | Jack Cheng-tsung Hou | Urology | 1739 E Beverly Ave Ste 106, Kingman, AZ 86409 | 2009-01-12 |
| 1710184726 | Michele F Epstein | Internal Medicine | 3571 N Moore Street, Kingman, AZ 86409 | 2007-07-02 |
| 1013118306 | Conchita O Mercado | Dentist | 1101 Riata Valley Rd, Kingman, AZ 86409 | 2007-05-31 |
| 1366585945 | Deering Therapy Services Ltd | Occupational Therapist | 1841 Morrow Ave, Kingman, AZ 86409 | 2007-02-14 |
| Find all providers in zip 86409 | ||||
| Taxonomy Code | 101YS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134313729 | Tanja Gromala | Counselor | 3175 Gordon Dr, Kingman, AZ 86409-3303 | 2007-08-28 |
| 1801017157 | Kim Robbins | Counselor | 400 Grandview Avenue, Kingman, AZ 86401 | 2007-05-02 |
| 1245457266 | Emily Lynn Hall | Counselor | 500 Maple Street, Kingman, AZ 86401 | 2007-04-19 |
| 1841405180 | Anne Marie Bathauer | Counselor | 4182 N Bank St, Kingman, AZ 86409-2715 | 2007-05-11 |
| 1235343583 | Theresa Vila Grumbles | Counselor | 4182 N Bank St, Kingman, AZ 86409-2715 | 2007-05-09 |
| 1467665000 | James Gunton | Counselor | 4182 N Bank St, Kingman, AZ 86409-2715 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215595707 | Danielle Payne | Counselor | 4145 E Montecito St, Tucson, AZ 85711-4734 | 2019-05-30 |
| 1780135533 | Eva Tomashefski | Counselor | 11011 N 92nd St, #1121, Scottsdale, AZ 85260-6137 | 2016-10-17 |
| 1275905754 | A & G Child Care Center LLC | Counselor | 537 E Racine Pl, Casa Grande, AZ 85122-1611 | 2015-10-23 |
| 1235547654 | Brian Prince | Counselor | 837 W Colter St, Apt. 51, Phoenix, AZ 85013-2269 | 2014-07-29 |
| 1750703682 | Amber Pedersen | Counselor | 1312 E Hale St, Mesa, AZ 85203-3818 | 2014-01-12 |
| 1023399227 | Sarah Joy Steele | Counselor | 7275 W Vineyard Rd, Laveen, AZ 85339-9805 | 2011-08-31 |
| 1255639902 | Sylvia Nockideneh-tee | Counselor | East Fir Street, Tuba City Junior High, Tuba City, AZ 86045 | 2011-03-04 |
| 1851600597 | Denisse Leon-uribe | Counselor | 3689 W Pageant Pl, Yuma, AZ 85364-3262 | 2010-09-29 |
| 1457689259 | Perla Nora Gonzalez | Counselor | 5832 W Ivanhoe St, Chandler, AZ 85226-1846 | 2009-12-07 |
| 1649508441 | Jennifer Palomares | Counselor | 8706 W Morten Ave, Glendale, AZ 85305-3945 | 2009-12-07 |
| Find all providers with the same taxonomy | ||||
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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.