Chaddrick Polk, PT, OTA

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1309289 Issued in TX

Practice address

4261 E University Dr Ste 30-165
Prosper, TX 75078

Phone

(972) 347-9604

Fax

(972) 499-2527

NPI assigned

Oct 4, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Just 4 Kidz Therapy, LLC

  • Home Health Agency
  • Prosper, TX
  • NPI 1114189420
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1443916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1003286972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4261 E UNIVERSITY DR STE 30-165",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "750789152",
            "telephone_number": "972-347-9454",
            "fax_number": "972-499-2527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4261 E UNIVERSITY DR STE 30-165",
            "city": "PROSPER",
            "state": "TX",
            "postal_code": "75078",
            "telephone_number": "972-347-9604",
            "fax_number": "972-499-2527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "CHADDRICK",
        "credential": "PT, OTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-04",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "213531",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1309289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pinnacle HC LLC
• Nicole Renee Pitts, D.O.
• Pivot Physio
• Eli Piyevsky
• Krista Plasky, LPC ASSOCIATE
• Mark Robert Polle, DDS
• Heather Marie Porter, O.D.
• Oladuni Porter
• Potters Touch Home Health, Inc.
• Shelby Powe, LMT

• Physical Therapist in Prosper, TX
• Providers in Prosper, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.