KENNETH K POTTS (C.R.N.A.) – Certified Registered Nurse Anesthetist, NPI 1316960404

KENNETH K POTTS (C.R.N.A.) is a healthcare provider. based in Mendota, Illinois. specializing in Certified Registered Nurse Anesthetist. They hold the professional credentials C.R.N.A.. They hold a License No. 041136641 (IL). The NPI Number for KENNETH K POTTS (C.R.N.A.) is 1316960404

Main info

Male
59 Years Of Experience
Accepts Medicare Assignment
Name
KENNETH K POTTS (C.R.N.A.)
NPI
1316960404
Phone
(815) 539-7461
Address
1401 EAST 12TH STREET
Enumeration Date
26 July 2006
Last Update Date
30 December 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8155397461
Graduation Year
1967 (59 years ago)
PAC ID
8527241777
Group Practice PAC ID
2264335777
Professional Enrollment ID
I20110324000731
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for KENNETH K POTTS (C.R.N.A.)

  • OSF Saint Paul Medical Center, 1401, East 12th Street, Mendota, Mendota Township, LaSalle County, Illinois, 61342, United States

    MENDOTA, IL 613429216

    Phone: (815) 539-7461

    Fax: (815) 539-1461

    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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 61342)

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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: 2264335777View full group profile
NameSpecialtyState
TIFFANY ANN SHINNICK
Nurse PractitionerIL
DR. MICHAEL S MORROW (MD)
Internal MedicineIL
MELISSA ELVIRA RAMIREZ (MSN, FNP-C)
Nurse PractitionerIL
BRENNAN T REEDER (PA-C)
Physician AssistantIL
KAREN L EGGERS (FNP-BC)
Nurse PractitionerIL
MADDALENA DAVENPORT (APRN)
Nurse PractitionerIL
MARITZA YESENIA ESTRADA-O'BRIEN
Family PracticeIL
DR. GRANT M REED (DO)
Family PracticeWI
KEITH CHRISTENSEN (APN, FNP)
Nurse PractitionerIL
DEBRA HERZ (FNP-BC)
Nurse PractitionerIL

Reviews

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Frequently asked questions

Does KENNETH K POTTS (C.R.N.A.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KENNETH K POTTS (C.R.N.A.) uses 1316960404.
Is KENNETH K POTTS (C.R.N.A.) still practicing?
KENNETH K POTTS (C.R.N.A.) is currently listed as active in the public NPI registry.
What healthcare role does KENNETH K POTTS (C.R.N.A.) hold?
Scheduling teams often label KENNETH K POTTS (C.R.N.A.) under Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where should I expect KENNETH K POTTS (C.R.N.A.) on a map?
Expect Mendota, Illinois as a primary anchor for KENNETH K POTTS (C.R.N.A.) unless the record lists multiple sites.
Why does KENNETH K POTTS (C.R.N.A.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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