Physician Compare National (NPI:1386899086)

HEALTHCARE PROVIDER: DANIEL EPHRAIM POTT-PEPPERMAN PSY.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1386899086
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6709934979
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090427000359
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	POTT PEPPERMAN
	Individual professional last name
Provider First Name	DANIEL
	Individual professional first name
Provider Middle Name	EPHRAIM
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	200 S 8TH AVE E
	Group Practice or individual's line 1 address
Line 2 Street Address	NEWTON HEALTHCARE CENTER
	Group Practice or individual's line 2 address
City	NEWTON
	Group Practice or individual's city
State	IA
	Group Practice or individual's state
Zip Code	502084762
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y