MEDICARE: SARAH MICHELLE POTTER PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	001004094	NC
2	363A00000X	Physician Assistant	2016027984	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215278429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MICHELLE POTTER PA-C

Provider Business Mailing Address
First Line	:	3515 BROADWAY BLVD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2501
Country	:	US
Telephone Number	:	816-753-5144
Fax Number	:	816-753-0804

Provider Business Practice Location Address
First Line	:	4309 E 50TH TER STE 200
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64130-8500
Country	:	US
Telephone Number	:	816-561-8784
Fax Number	:	816-442-8395

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2013
Last Update Date	:	03/31/2025

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Directions to “ SARAH MICHELLE POTTER PA-C” Practice Location

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