Kenneth K Potts (NPI# 1316960404, PAC ID# 8527241777) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA).
| Nation Provider ID (NPI) | 1316960404 |
| PAC ID by PECOS | 8527241777 |
| Professional Enrollment ID | I20110324000731 |
| Full Name | Kenneth K Potts |
| Organization Legal Name | MENDOTA COMMUNITY HOSPITAL |
| Address |
1401 E 12th St Mendota IL 61342-9216 |
| Phone Number | 8155397461 |
| Gender | M |
| Graduation Year | 1967 |
| Primary Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| Group Practice PAC ID | 2264335777 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 141310 | OSF SAINT PAUL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1401 E 12th St, Mendota, IL 61342-9216 | 8155397461 | MENDOTA COMMUNITY HOSPITAL |
| Organization Legal Name | MENDOTA COMMUNITY HOSPITAL |
| Physicians | 8 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Katherine R Riva Foster | Certified Registered Nurse Anesthetist (crna) | Mendota Community Hospital | 1401 E 12th St, Mendota, IL 61342-9216 |
| Mary M Chinn | Family Medicine | Mendota Community Hospital | 1404 Washington St, Mendota, IL 61342-1471 |
| Amy M Matheis Soliman | Family Medicine | Mendota Community Hospital | 1401 E 12th St, Mendota, IL 61342-9216 |
| Leonardo Lopez | Family Medicine | Mendota Community Hospital | 1401 E 12th St, Mendota, IL 61342-9216 |
| Stacy A Piller | Nurse Practitioner | Mendota Community Hospital | 1405 E 12th St, 600 Physician Services of Mch, Mendota, IL 61342-9012 |
| David A Scholl | Family Medicine | Mendota Community Hospital | 1405 E 12th St, 600 Physician Services of Mch, Mendota, IL 61342-9012 |
| Zachary J Fulton | Family Medicine | Mendota Community Hospital | 1404 Washington St, Mendota, IL 61342-1471 |
| Street Address |
1401 E 12TH ST |
| City | MENDOTA |
| State | IL |
| Zip | 61342-9216 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Katherine R Riva Foster | Certified Registered Nurse Anesthetist (crna) | Mendota Community Hospital | 1401 E 12th St, Mendota, IL 61342-9216 |
| Kenneth W Fraser | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 1401 E 12th St, Mendota, IL 61342-9216 |
| Robert W Schmidt | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 1401 E 12th St, Mendota, IL 61342-9216 |
| Kim Veronica Arellano Villarreal | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 1401 E 12th St, Mendota, IL 61342-9216 |
| Christopher J Differding | Physician Assistant | Illinois Urologic Health Surgeons Sc | 1401 E 12th St, Mendota, IL 61342-9216 |
| Amy M Matheis Soliman | Family Medicine | Mendota Community Hospital | 1401 E 12th St, Mendota, IL 61342-9216 |
| Leonardo Lopez | Family Medicine | Mendota Community Hospital | 1401 E 12th St, Mendota, IL 61342-9216 |
| Michael T Zagardo | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 1401 E 12th St, Mendota, IL 61342-9216 |
| Mark H Goergen | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 1401 E 12th St, Mendota, IL 61342-9216 |
| Jessica A Guingrich | Diagnostic Radiology | Central Illinois Radiological Associates Ltd | 1401 E 12th St, Mendota, IL 61342-9216 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Linnea L Person | Chiropractic | 1301 14th Ave, Mendota, IL 61342-1001 | |
| Cynthia A Becker | Chiropractic | 1403 E Main St, Mendota, IL 61342-1077 | |
| Donald W Piller | Chiropractic | 1312 Lakewood Dr, Mendota, IL 61342-1096 | |
| Tara N Vandewyngaerde | Optometry | 700 14th Ave, Mendota, IL 61342-1412 | |
| Mary M Chinn | Family Medicine | Mendota Community Hospital | 1404 Washington St, Mendota, IL 61342-1471 |
| Zachary J Fulton | Family Medicine | Mendota Community Hospital | 1404 Washington St, Mendota, IL 61342-1471 |
| Joy R Preciado | Nurse Practitioner | Community Health Partnership of Illinois | 1009 Main St, Mendota, IL 61342-1604 |
| Rebecca J Amble | Clinical Social Worker | Illinois Valley Counseling Services | 901 Main St, Suite A, Mendota, IL 61342-1682 |
| Dawn H Mccollom | Clinical Social Worker | Illinois Valley Counseling Services | 901 Main St, Suite A, Mendota, IL 61342-1682 |
| Mary A Liddle | Clinical Social Worker | Illinois Valley Counseling Services | 901 Main St, Mendota, IL 61342-1682 |
| Find all physicians in zip 61342 | |||
| City | MENDOTA |
| Zip Code | 61342 |
| Specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
| City + Specialty | MENDOTA + CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.