Dr. Samuel B Potter (NPI# 1376074674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider Identifier (NPI) | 1376074674 |
| Entity Type | Individual |
| Full Name | Dr. Samuel B Potter |
| Credential | M.D. |
| Gender | Male |
| Practice Address |
Maine Medical Center 22 Bramhall Street Portland ME 04102 |
| Practice Telephone | 2076620111 |
| Mailing Address |
Maine Medical Center 22 Bramhall Street Portland ME 04102 |
| Sole Proprietor | No, this individual is not a Sole Proprietor |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2019-07-11 |
| Primary | Taxonomy | Classification | Taxonomy Group | License Number | State |
|---|---|---|---|---|---|
| Yes | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | MD22649 | ME |
| No | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Medical Center Drive, Biddeford, ME 04005 | 2072945000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306473889 | Samuel Potter | Student in an Organized Health Care Education/Training Program | 245 Fountain Court, Lexington, KY 40509 | 2020-03-25 |
| NPI | 1376074674 |
| PAC ID by PECOS | 5597094862 |
| Professional Enrollment ID | I20190911002996 |
| Full Name | Samuel B Potter |
| Organization Legal Name | MAINEHEALTH |
| Phone Number | 2072837600 |
| Gender | M |
| Medical School | STATE UNIVERSITY OF NEW YORK AT STONY BROOK, SCHOOL OF MEDICINE |
| Graduation Year | 2017 |
| Primary Specialty | EMERGENCY MEDICINE |
| Group Practice PAC ID | 7517860588 |
| Number of Group Practice Members | 1115 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 200019 | SOUTHERN MAINE HEALTH CARE |
| 200037 | FRANKLIN MEMORIAL HOSPITAL |
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912361718 | Bryce Edwards | Emergency Medicine | 3181 Sw Sam Jackson Park Road, Ohsu, Portland, OR 97239 | 2016-04-07 |
| 1073907978 | Karen Ta | Emergency Medicine | 10300 Se Main St, Portland, OR 97216 | 2015-03-27 |
| 1104210921 | Elizabeth Hatfield | Emergency Medicine | 3181 Sw Sam Jackson Park Rd # Cdw, Portland, OR 97239-3011 | 2015-03-19 |
| 1699171918 | Stephen Boyer | Emergency Medicine | 3708 Sw Lyle Ct, Portland, OR 97221-3963 | 2014-11-13 |
| 1679991590 | Meaghan Dehning | Emergency Medicine | 3181 Sw Sam Jackson Park Rd # Em, Portland, OR 97239-3011 | 2014-03-29 |
| 1942647185 | Jason F Hine | Emergency Medicine | E1 Clairmont Ct, Portland, ME 04103-4459 | 2013-05-29 |
| 1487900742 | Aaron Vitells | Emergency Medicine | 2424 Ne 41st Ave, Portland, OR 97212-5423 | 2012-07-24 |
| 1073870895 | Marcus Alyn Chiodo | Emergency Medicine | 10000 Se Main St Ste 40, Adventist Medical Center - The Pavilion, Portland, OR 97216-2461 | 2012-04-18 |
| 1184913147 | Jerry L Lawrence | Emergency Medicine | 11705 Nw Timberview Ln, Apt 204, Portland, OR 97229-6659 | 2011-03-30 |
| 1093959280 | Mark Paul Vantighem | Emergency Medicine | Ohsu 3181 Sw Sam Jackson Park Road, Portland, OR 97239 | 2009-05-01 |
| Find all providers in PORTLAND | ||||
| Street Address |
MAINE MEDICAL CENTER 22 BRAMHALL STREET |
| City | PORTLAND |
| State | ME |
| Zip Code | 04102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609437888 | Zachary Chaloner | Physical Medicine & Rehabilitation | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102-3134 | 2019-06-27 |
| 1316504863 | Megan W Rand | Physician Assistant | Maine Medical Center, 22 Bramhall St, Portland, ME 04102 | 2019-05-21 |
| 1235690504 | Isabelle Lane Curran | Student in an Organized Health Care Education/Training Program | Maine Medical Center, 22 Bramhall St, Portland, ME 04102 | 2019-03-28 |
| 1548765043 | William August White | Student in an Organized Health Care Education/Training Program | Maine Medical Center, 22 Bramhall Street, Portland, ME 04102 | 2018-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720602964 | Ci Yen Joanna Man | Student in an Organized Health Care Education/Training Program | 190 Park Ave., Portland, ME 04102 | 2020-06-03 |
| 1841811338 | Abby Zarotny Sahagian | Nurse Anesthetist, Certified Registered | Mmc Anesthesia and Perioperative Medicine, 22 Bramhall St, Portland, ME 04102 | 2020-05-06 |
| 1124656863 | Zachary Bernard Tillett | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall St., Portland, ME 04102 | 2020-03-30 |
| 1215564323 | Joshua Allen Swenson | Student in an Organized Health Care Education/Training Program | 33 Bramhall St, Portland, ME 04102 | 2020-03-26 |
| 1740776434 | Rishi Phakey | Dentist | Community Dental, 190 Park Ave, Portland, ME 04102 | 2018-07-05 |
| 1982192571 | Jessica Thomas | Doula | 619 Brighton Ave #101, Rosemont Wellness Center, Portland, ME 04102 | 2018-04-29 |
| 1699270744 | Shane D Kirkegaard | Student in an Organized Health Care Education/Training Program | Maine Medical Center 22 Bramhall Street, Portland, ME 04102 | 2018-03-29 |
| 1144752494 | Al-shawk Home Healthcare, LLC | Technician | 640 Brighton Ave Ste 8, Portland, ME 04102 | 2017-03-28 |
| 1043767536 | Kevin De Ruiter | Social Worker | 129 Pine St Apt 6, Portland, ME 04102 | 2016-09-01 |
| 1053786525 | Stephanie Mollica | Social Worker | 22 Bramhall Strret, Portland, ME 04102 | 2015-12-09 |
| Find all providers in zip 04102 | ||||
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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.