DERICK AARON POTTER (ARNP) – Nurse Practitioner, NPI 1811355803

DERICK AARON POTTER (ARNP) is a healthcare provider. based in Chehalis, Washington. specializing in NURSE PRACTITIONER. They hold the professional credentials ARNP. They hold a License No. AP60630477 (WA). The NPI Number for DERICK AARON POTTER (ARNP) is 1811355803

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
DERICK AARON POTTER (ARNP)
NPI
1811355803
Phone
(360) 330-9595
Address
2690 NE KRESKY AVE
Enumeration Date
4 February 2016
Last Update Date
4 February 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3609964443
Graduation Year
2015 (11 years ago)
PAC ID
7214223833
Group Practice PAC ID
8426365412
Professional Enrollment ID
I20160908000957
Address ID
WA985322600CH34XXXSTXX419
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

6,261 NURSE PRACTITIONER in WA

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Provider Addresses for DERICK AARON POTTER (ARNP)

  • 2690, Northeast Kresky Avenue, Chehalis, Lewis County, Washington, 98532, United States

    CHEHALIS, WA 985322412

    Phone: (360) 330-9595

    Fax: (360) 330-9530

    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)

CMS reports 4 Open Payments records for all available years, with a total value of $170.

Total Amount is formed as General ($170) + Research ($0) + Ownership ($0) = $170.

Last reported payment date: 2024-09-17 • Largest payer in this snapshot: Lilly USA, LLC ($82).

Total Amount

$170

General + Research + Ownership

Payments

4

Total payment records

General Amount

$170

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2016-09-08

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
I20160908000957INurse PractitionerWATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99349Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes10533$0
99350Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes3118$0
View full utilization report →

Insurance plans in this area (ZIP 98532)

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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: 8426365412View full group profile
NameSpecialtyState
Nurse PractitionerWA
Nurse PractitionerMI

Reviews

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Frequently asked questions

What unique ID ties claims to DERICK AARON POTTER (ARNP)?
NPI 1811355803 is assigned to DERICK AARON POTTER (ARNP) under the national enumeration system.
Is DERICK AARON POTTER (ARNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does DERICK AARON POTTER (ARNP) work in?
You can think of DERICK AARON POTTER (ARNP) as practicing within Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where does public data place DERICK AARON POTTER (ARNP)?
The snapshot lists Chehalis, Washington for DERICK AARON POTTER (ARNP); download NPPES for the complete set.
Is DERICK AARON POTTER (ARNP) a real provider?
This page reflects official NPPES data for NPI 1811355803. Always confirm identity and privileges with the practice and licensing boards.

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