RANDOLPH GERALD POTTS (PH.D.) – Clinical Psychologist, NPI 1154434413
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
400 CLINICAL PSYCHOLOGIST in TN
Provider Addresses for RANDOLPH GERALD POTTS (PH.D.)
1325 Eastmoreland Ave Ste 370
Memphis, TN 381047542
Phone: (901) 516-8785
Fax: (901) 516-8358
Type: Location
1325 EASTMORELAND AVE STE 101
MEMPHIS, TN 381043507
Phone: (901) 516-8785
Fax: (901) 516-8358
Type: Location
1211 UNION AVE STE 330
MEMPHIS, TN 381046655
Phone:
Type: Mailing
1265 UNION AVE
2 SHORB TOWER
MEMPHIS, TN 38104
Phone: (901) 478-5330
Fax: (901) 478-8358
Type: Location
1835, Union Avenue, Union Ave, Midtown, Memphis, Shelby County, Tennessee, 38104, United States
SUITE 315
MEMPHIS, TN 381043921
Phone: (901) 726-1284
Type: Location
Benjestown Road, Memphis, Shelby County, West Tennessee, Tennessee, 38127, United States
MEMPHIS, TN 381273135
Phone: (901) 353-0774
Type: Mailing
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.
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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: 2004-05-11
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040511000531 | I | Clinical Psychologist | TN | TBD |
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.
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 38104)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | TN | |
| - | TN | |
| Physician Assistant | TN | |
| Hematology/Oncology, Internal Medicine | TN | |
| - | TN | |
| - | TN | |
| N E U R O L O G Y | TN | |
| Nurse Practitioner | GA | |
| Infectious Disease, Internal Medicine | TN | |
| General Surgery | TN |
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