{"npi":"1144873159","type":"NPI-1","status":"active","name":{"display":"Stephanie Potts PHD","other":[],"first":"STEPHANIE","last":"POTTS","middle":"ROSS","credential":"PHD"},"specialty":{"primary_taxonomy":"103G00000X","primary_taxonomy_description":"Clinical Neuropsychologist","slug":"clinical-neuropsychologist","schema_org_specialty":null,"all":[{"code":"103T00000X","description":"Psychologist","primary":false,"state":"MO","license":"2018013237"},{"code":"103T00000X","description":"Psychologist","primary":false,"state":"IL","license":"071.010747"},{"code":"103G00000X","description":"Clinical Neuropsychologist","primary":true,"state":"WI","license":"5131"},{"code":"103G00000X","description":"Clinical Neuropsychologist","primary":false,"state":"IL","license":"071.010747"},{"code":"103G00000X","description":"Clinical Neuropsychologist","primary":false,"state":"MO","license":"2018013237"}]},"addresses":[{"purpose":"LOCATION","street_1":"700 N WESTHAVEN DR","city":"OSHKOSH","state":"WI","postal_code":"549046947","country_code":"US","phone":"9204562030"},{"purpose":"MAILING","street_1":"PO BOX 735044","city":"CHICAGO","state":"IL","postal_code":"606735044","country_code":"US","phone":"8003262250"}],"license":{"state":"WI","number":"5131"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"100266414","state":"WI","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20191002000135","type_code":"14-68","type_desc":"PRACTITIONER - CLINICAL PSYCHOLOGIST","state":"MO","pac_id":"1254661432"},{"enrlmt_id":"I20230530002046","type_code":"14-68","type_desc":"PRACTITIONER - CLINICAL PSYCHOLOGIST","state":"IL","pac_id":"1254661432"},{"enrlmt_id":"I20240305000850","type_code":"14-68","type_desc":"PRACTITIONER - CLINICAL PSYCHOLOGIST","state":"WI","pac_id":"1254661432"}]},"enumeration_date":"2019-07-18","last_updated":"2024-09-10","_meta":{"source":"NPPES","snapshot_date":"2024-09-10","doc_url":"https://findmynpi.com/api"}}