TIFFANY HELYN POTTER (FNP) – Nurse Practitioner, NPI 1962740985

TIFFANY HELYN POTTER (FNP) is a healthcare provider. based in Canadian, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP. They hold a License No. 625274 (TX). The NPI Number for TIFFANY HELYN POTTER (FNP) is 1962740985

Main info

Female
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
TIFFANY HELYN POTTER (FNP)
NPI
1962740985
Phone
(806) 323-8882
Address
1010 S 4TH ST
Enumeration Date
25 January 2013
Last Update Date
27 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8063236422
Graduation Year
2012 (14 years ago)
PAC ID
6406091966
Group Practice PAC ID
4587652078
Professional Enrollment ID
I20130404000215
Address ID
TX790143315CA1020XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

22,209 NURSE PRACTITIONER in TX

Provider Addresses for TIFFANY HELYN POTTER (FNP)

  • 1010 S 4TH ST

    CANADIAN, TX 790143315

    Phone: (806) 323-8882

    Fax: (806) 323-6108

    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: 2013-04-04

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
I20130404000215INurse PractitionerTXTBD

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 79014)

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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: 4587652078View full group profile
NameSpecialtyState
Nurse PractitionerTX
Clinical Social WorkerTX
Family PracticeTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Family PracticeTX

Reviews

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Frequently asked questions

What unique ID ties claims to TIFFANY HELYN POTTER (FNP)?
NPI 1962740985 is assigned to TIFFANY HELYN POTTER (FNP) under the national enumeration system.
Is TIFFANY HELYN POTTER (FNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize TIFFANY HELYN POTTER (FNP)'s specialty in plain language?
Clinically, the directory lists TIFFANY HELYN POTTER (FNP) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place TIFFANY HELYN POTTER (FNP)?
The snapshot lists Canadian, Texas for TIFFANY HELYN POTTER (FNP); download NPPES for the complete set.
What if Canadian, Texas seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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