CLINTON WAYNE POTTER PA-C
NPI 1255610168
Physician Assistant in Salt Lake City, UT

Q: What is Clinton Potter's NPI number?

The NPI number for Clinton Potter is 1255610168. It was assigned to this individual provider in the NPPES registry on August 9, 2011.

Q: What is Clinton Potter's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Clinton Potter was last updated on January 12, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 09, 2011PECOS Enrolled

144 S 500 E, SALT LAKE CITY, UT 84102(801) 463-7415 Get Directions Write a Review

NPPES record last updated: January 12, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Clinton Wayne Potter Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLINTON WAYNE POTTER PA-C (NPI 1255610168) is an individual physician assistant in Salt Lake City, Utah, licensed in Pennsylvania (1098530) and active in the NPI registry since August 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255610168

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameCLINTON WAYNE POTTERCredential: PA-C

Location Address144 S 500 ESalt Lake City, UT 84102-1907

Mailing Address2257 North Oak Hallow DriveLayton, UT 84040 · (801) 660-7917

Phone(801) 463-7415

Sole ProprietorNo

Enumeration DateAugust 9, 2011

Last NPPES UpdateJanuary 12, 2015

✔ NPI 1255610168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in PA · 1098530

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

144 S 500 E, Salt Lake City, UT 84102

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Clinton Wayne Potter Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

45 services38 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

43 services43 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

14 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84102 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.41 typical visit price

range $54.34 – $166.03

Typical copayment $21.10 (range $13.58 – $41.50)

Most-billed visit code 99203

Established Patient

$68.01 typical visit price

range $17.23 – $135.20

Typical copayment $17.00 (range $4.30 – $33.80)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SCOTT HARTLEY FREDRICKSON MD

Emergency Medicine

144 S 500 E
SLC, UT 84102

Salt Lake County (801) 463-7415

DR. TIMOTHY J GAYOWSKI MD FACS

Internal Medicine (Critical Care Medicine)