HOLLY A POTTER DC
NPI 1447721048
Chiropractor in Rochester, NY

Q: What is Holly Potter's NPI number?

The NPI number for Holly Potter is 1447721048. It was assigned to this individual provider in the NPPES registry on December 8, 2018.

Q: What is Holly Potter's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Q: When was this NPI record last updated?

The NPPES record for Holly Potter was last updated on June 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 December 08, 2018Accepts Medicare Assignment

2005 LYELL AVE STE 115, ROCHESTER, NY 14606(585) 458-2679(585) 219-5660 Get Directions Write a Review

NPPES record last updated: June 6, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 6, 2019, Dec 8, 2018 (2 updates tracked since 2018).

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About Holly A Potter Dc NPPES

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

HOLLY A POTTER DC (NPI 1447721048) is an individual chiropractor in Rochester, New York, licensed in New York (013202) and active in the NPI registry since December 2018. She is a graduate of New York Chiropractic College (2018).

NPPES Registry Identity

NPI1447721048

Entity TypeIndividualFemale

Primary Taxonomy111N00000X

Provider Legal NameHOLLY A POTTERCredential: DC

Location Address2005 LYELL AVE STE 115Rochester, NY 14606-2325

Mailing Address210 Phoenix Mills PlzVictor, NY 14564-1414

Phone(585) 458-2679

Fax(585) 219-5660

Sole ProprietorNo

Medical School CMSNew York Chiropractic CollegeGraduated 2018

Enumeration DateDecember 8, 2018

Last NPPES UpdateJune 6, 20192 updates tracked since enumeration

✔ NPI 1447721048 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers

Taxonomy Code111N00000X

License✔ Licensed in NY · 013202

Definition

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

2005 LYELL AVE STE 115, Rochester, NY 14606

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Holly A Potter Dc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496194599

PECOS Enrollment IDI20240423001512

Medicare Billing Reassignment

Medicare enrollment records show Holly Potter reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Stonegate Chiropractic PLLC

Same address

Chiropractor

2005 LYELL AVE, SUITE 115
Rochester, NY 14606

Reassigned Medicare billing, New York enrollment
3 clinicians in this Medicare group

NPI 1043668510 (585) 458-2679

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Holly Potter's NPI number?

The NPI number for Holly Potter is 1447721048. It was assigned to this individual provider in the NPPES registry on December 8, 2018.

Where is Holly Potter located?

Holly Potter practices at 2005 Lyell Ave Ste 115, Rochester, NY 14606. The listed phone number is (585) 458-2679.

What is Holly Potter's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Holly Potter enrolled in Medicare?

Yes. Holly Potter is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Holly Potter's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Holly Potter reassigns Medicare benefits to Stonegate Chiropractic PLLC (Rochester, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Holly Potter's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Holly Potter was last updated on June 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.