Individual provider Active NPI

Faith Lawrence Polkey, M.D., M.P.H.

  • Pediatrics Physician
  • Port Royal, SC
National Provider Identifier
1003885526
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
23511 Issued in SC
Practice address
1320 Ribaut Rd
Port Royal, SC 29935-1118
Phone
(843) 986-0900
Fax
(843) 322-1875
NPI assigned
Mar 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 23511 SC Primary

Addresses

Primary practice location

1320 Ribaut Rd
Port Royal, SC 29935-1118

Mailing address

1320 Ribaut Rd
Port Royal, SC 29935-1118
Phone (843) 986-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080908000314 SC Practitioner - Pediatric MedicinePractitioner - Preventive Medicine 5799851218 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23511SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort Jasper Hampton Comprehensive Health Services, Inc. CurrentSince Jan 1, 2016 Accepting new patients

Locations

721 Okatie Hwy
Okatie, SC 29909

1320 Ribaut Rd
Port Royal, SC 29935
Phone (843) 322-1833

721 N Okatie Hwy
#170
Ridgeland, SC 29936

Interoperability endpoints

  • Direct secure messaging: faith.polkey@bjhchs.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/EICIBD/Endpoint/EICIBD

Ownership & related parties

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
BjhchsRidgeland, SC, CCN 421809 Federally qualified health center Operational/Managerial Control Apr 7, 2022
Leroy E. Browne Medical CenterSaint Helena Island, SC, CCN 421911 Federally qualified health center Corporate Officer
Operational/Managerial Control
Apr 7, 2022
Apr 17, 2022
Port Royal Medical Center IIPort Royal, SC, CCN 421047 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control
Apr 17, 2022
Apr 17, 2022
Apr 17, 2022
Varnville Medical CenterVarnville, SC, CCN 421116 Federally qualified health center Operational/Managerial Control Apr 17, 2022
Bjhchs Mobile UnitOkatie, SC, CCN 421131 Federally qualified health center Corporate Officer
W-2 Managing Employee
Operational/Managerial Control
Apr 17, 2022
Apr 17, 2022
Apr 17, 2022

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1003885526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 RIBAUT RD",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299351118",
            "telephone_number": "843-986-0900",
            "fax_number": "843-322-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 RIBAUT RD",
            "city": "PORT ROYAL",
            "state": "SC",
            "postal_code": "299351118",
            "telephone_number": "843-986-0900",
            "fax_number": "843-322-1875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLKEY",
        "first_name": "FAITH",
        "middle_name": "LAWRENCE",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "23511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Royal, SC

Sources for this page

Verify at the official NPI Registry.