LAN POTTER (NURSE PRACTITIONER) – Primary Care Nurse Practitioner, NPI 1003640335

LAN POTTER (NURSE PRACTITIONER) is a healthcare provider. based in Ellenton, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials NURSE PRACTITIONER. They hold a License No. APRN11032275 (FL). The NPI Number for LAN POTTER (NURSE PRACTITIONER) is 1003640335

Main info

Female
3 Years Of Experience
Accepts Medicare Assignment
Name
LAN POTTER (NURSE PRACTITIONER)
NPI
1003640335
Phone
(319) 671-2270
Address
2640 57TH CIR E APT 202
Enumeration Date
29 August 2024
Last Update Date
29 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3526331966
Graduation Year
2023 (3 years ago)
PAC ID
8628581733
Group Practice PAC ID
0345427019
Professional Enrollment ID
I20250701004602
Address ID
FL321621762TH1050XRDXX406
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for LAN POTTER (NURSE PRACTITIONER)

  • 2640 57TH CIR E APT 202

    2640 57TH CIR E APT 202

    ELLENTON, FL 34222

    Phone: (319) 671-2270

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-07-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250701004602INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 34222)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345427019View full group profile
NameSpecialtyState
-FL
Interventional CardiologyIA
-FL
-FL
Nurse PractitionerFL
Nurse PractitionerGA
Cardiovascular Disease (Cardiology)FL
Interventional CardiologyPA
Interventional Cardiology, Cardiovascular Disease (Cardiology)NY
Cardiovascular Disease (Cardiology), Internal MedicineFL

Reviews

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Frequently asked questions

Can I use this page to confirm LAN POTTER (NURSE PRACTITIONER)'s NPI?
Yes. LAN POTTER (NURSE PRACTITIONER) is listed with NPI 1003640335 in the public NPI dataset.
Is LAN POTTER (NURSE PRACTITIONER) still practicing?
LAN POTTER (NURSE PRACTITIONER) is currently listed as active in the public NPI registry.
What taxonomy line describes LAN POTTER (NURSE PRACTITIONER)?
For research purposes, treat LAN POTTER (NURSE PRACTITIONER) as Primary Care Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does LAN POTTER (NURSE PRACTITIONER) serve?
LAN POTTER (NURSE PRACTITIONER)'s listing highlights Ellenton, Florida; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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