Randolph Gerald Potts, PHD in Memphis, TN - Medicare Psychologist Provider

Randolph Gerald Potts, PHD is a medicare enrolled "Psychologist - Clinical" provider in Memphis, Tennessee. His current practice location is 1325 Eastmoreland Ave Ste 101, Memphis, Tennessee. You can reach out to his office (for appointments etc.) via phone at (901) 516-8785.

Randolph Gerald Potts is licensed to practice in Tennessee (license number 2490) 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 1154434413.

Contact Information

	Randolph Gerald Potts, PHD
	1325 Eastmoreland Ave Ste 101, Memphis, TN 38104-3507
	(901) 516-8785
	(901) 516-8358

Map and Direction

Healthcare Provider's Profile

Full Name	Randolph Gerald Potts
Gender	Male
Speciality	Psychologist - Clinical
Location	1325 Eastmoreland Ave Ste 101, Memphis, Tennessee
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1154434413
Provider Enumeration Date: 08/17/2006
Last Update Date: 12/14/2021

Medicare PECOS Information:

PECOS PAC ID: 1557350972
Enrollment ID: I20040511000531

Medical Identifiers

Medical identifiers for Randolph Gerald Potts such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1154434413	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
103T00000X	Psychologist	P0000002490 (Tennessee)	Secondary
103TC0700X	Psychologist - Clinical	2490 (Tennessee)	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. Randolph Gerald Potts allows following entities to bill medicare on his behalf.

Entity Name	Ut Methodist Physicians Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427317908 PECOS PAC ID: 2769623669 Enrollment ID: O20130718000263

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. Randolph Gerald Potts 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
Randolph Gerald Potts, PHD 1211 Union Ave Ste 330, Memphis, TN 38104-6655 Ph: (901) 478-0954	Randolph Gerald Potts, PHD 1325 Eastmoreland Ave Ste 101, Memphis, TN 38104-3507 Ph: (901) 516-8785

Reviews and Comments

Psychologist in Memphis, TN

Boaz Roderick Futch, PHD.PSY Psychologist Medicare: Not Enrolled in Medicare Practice Location: 952 Decatur St, Memphis, TN 38107 Phone: 901-644-5713
Ms. Heather Marie Conklin, PHD Psychologist Medicare: Medicare Enrolled Practice Location: 262 Danny Thomas Pl, Memphis, TN 38105 Phone: 901-595-3006 Fax: 901-595-3842
Teressa Davis Davis, PHD Psychologist Medicare: Not Enrolled in Medicare Practice Location: 815 N Mclean Blvd, Memphis, TN 38107 Phone: 901-614-1902
Dr. Lisa B. Alex, PH. D. Psychologist Medicare: Accepting Medicare Assignments Practice Location: 4646 Poplar Ave Ste 419, Memphis, TN 38117 Phone: 901-682-6555 Fax: 901-682-6901
Dr. Sean Phipps, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 262 Danny Thomas Pl, Memphis, TN 38105 Phone: 901-595-3006 Fax: 901-595-3842
Dr. Amy Renee Hershberger, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 1030 Jefferson Ave, Memphis, TN 38104 Phone: 901-523-8990
Dr. Colby Douglas Butzon, PH.D. Psychologist Medicare: Not Enrolled in Medicare Practice Location: 711 Jefferson Ave, Memphis, TN 38105 Phone: 901-448-6511 Fax: 901-448-7097

Randolph Gerald Potts, PHD - Medicare Psychologist in Memphis, TN