STEPHANIE KATHRYN POTTER M.D. NPI 1609892413

NPI Information

  • NPI: 1609892413
  • Provider Name: STEPHANIE KATHRYN POTTER, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1169 GRAND CENTRAL PKWY
    CONROE, TX
    ZIP 77304
  • Phone: (936) 525-3600

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NPI Details

Stephanie Kathryn Potter, M.D. is a family medicine in Conroe, TX with 20 years of experience. The provider is 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. Stephanie Kathryn Potter, M.D. NPI is 1609892413. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: BAYLOR COLLEGE OF MEDICINE
Graduation Year:2006

The provider's business location address is:

1169 GRAND CENTRAL PKWY
CONROE, TX
ZIP 77304-185
Phone: (936) 525-3600
Fax: (936) 525-3624

The NPI 1609892413 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/14/2006 and was last updated on 7/9/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineMD177584OREGONNo
2207Q00000XFamily MedicineMR-0872IDAHONo
3207Q00000XFamily MedicineM-10113IDAHONo
4207Q00000XFamily MedicineM-16783IDAHONo
5207Q00000XFamily MedicineN-3251TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11196215OTHERIDAHOMEDICARE PTAN
2P01009617OTHERIDAHOMEDICARE RAILROAD
31609892413MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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