Ethan Potter, LCSW in Springfield, MO - Medicare Social Worker Provider

Ethan Potter, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Springfield, Missouri. His current practice location is 1722 S Glenstone Ave Ste H, Springfield, Missouri. You can reach out to his office (for appointments etc.) via phone at (417) 224-7806.

Ethan Potter is licensed to practice in Missouri (license number 2021024924) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1275188799.

Contact Information

	Ethan Potter, LCSW
	1722 S Glenstone Ave Ste H, Springfield, MO 65804-1513
	(417) 224-7806
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Ethan Potter
Gender	Male
Speciality	Social Worker - Clinical
Location	1722 S Glenstone Ave Ste H, Springfield, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1275188799
Provider Enumeration Date: 08/02/2019
Last Update Date: 06/27/2024

Medicare PECOS Information:

PECOS PAC ID: 7012386493
Enrollment ID: I20221206003051

Medical Identifiers

Medical identifiers for Ethan Potter such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1275188799	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	(* (Not Available))	Secondary
1041C0700X	Social Worker - Clinical	2021024924 (Missouri)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ethan Potter allows following entities to bill medicare on his behalf.

Entity Name	Mercy Clinic Springfield Communities
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881636884 PECOS PAC ID: 7416865845 Enrollment ID: O20040823000021

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Potter is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Ethan Potter, LCSW 2135 E Independence St # 1033, Springfield, MO 65804-3749 Ph: (417) 224-7806	Ethan Potter, LCSW 1722 S Glenstone Ave Ste H, Springfield, MO 65804-1513 Ph: (417) 224-7806

Reviews and Comments

Social Worker in Springfield, MO

Mrs. Miriam E Green, M.S.W., L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1330 E Cherry St, Springfield, MO 65802 Phone: 417-862-1377
Renee Ann Jenkins, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1550 E Sunshine St, Springfield, MO 65804 Phone: 417-883-7500
Makayla Mae Stanton, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 230 N Belcrest Ave, Suite A, Springfield, MO 65802 Phone: 417-413-4676
Allison J Robertson, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 323 E Grand St, Springfield, MO 65807 Phone: 417-761-5600 Fax: 417-761-5601
Jessica A Aldrich, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1423 N Jefferson Ave Fl 3, Springfield, MO 65802 Phone: 417-761-5000
Linda E Maddox, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3263 E Lombard St, Springfield, MO 65802 Phone: 417-860-3705
Elizabeth Marie Mendenhall, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 440 S Market Ave, Springfield, MO 65806 Phone: 417-865-5581

Ethan Potter, LCSW - Medicare Clinical Social Worker in Springfield, MO