DR. ANN ELIZABETH POTTER (PHD) – Clinical Psychologist, NPI 1063491413

DR. ANN ELIZABETH POTTER (PHD) is a healthcare provider. based in Omaha, Nebraska. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 279 (NE). The NPI Number for DR. ANN ELIZABETH POTTER (PHD) is 1063491413

Main info

Female
38 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANN ELIZABETH POTTER (PHD)
NPI
1063491413
Phone
(402) 403-0190
Address
12822 AUGUSTA AVENUE
Enumeration Date
13 January 2006
Last Update Date
29 August 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4024030190
Graduation Year
1988 (38 years ago)
PAC ID
4284536749
Group Practice PAC ID
5092879148
Professional Enrollment ID
I20040123001014
Address ID
NE681541722OM638XXPLZX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

200 CLINICAL PSYCHOLOGIST in NE

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Provider Addresses for DR. ANN ELIZABETH POTTER (PHD)

  • Augusta Avenue, Westwood Heights, Millard, Omaha, Douglas County, Nebraska, 68144, United States

    OMAHA, NE 68144

    Phone: (402) 403-0190

    Fax: (402) 932-4121

    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: 2004-01-23

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
I20040123001014IClinical PsychologistNETBD

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 68144)

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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: 5092879148View full group profile
NameSpecialtyState
Mental Health CounselorNE
Mental Health CounselorNE
Mental Health CounselorNE
Mental Health CounselorNE
Clinical Social WorkerNE
Clinical Social WorkerNE
Mental Health CounselorNE
Mental Health CounselorNE
Mental Health CounselorNE
Mental Health CounselorNE

Reviews

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Frequently asked questions

Can I cross-check DR. ANN ELIZABETH POTTER (PHD) using NPI 1063491413?
NPI 1063491413 belongs to DR. ANN ELIZABETH POTTER (PHD); compare other details if you need extra assurance.
Is DR. ANN ELIZABETH POTTER (PHD) still an active registrant?
DR. ANN ELIZABETH POTTER (PHD) carries an active NPI according to the public dataset.
What area of care is associated with DR. ANN ELIZABETH POTTER (PHD)?
DR. ANN ELIZABETH POTTER (PHD)'s record emphasizes Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where in Nebraska is DR. ANN ELIZABETH POTTER (PHD) registered?
Use Omaha, Nebraska as the headline location for DR. ANN ELIZABETH POTTER (PHD) here.
Can I trust this NPI listing for DR. ANN ELIZABETH POTTER (PHD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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