Active NPI
Anne Frances Polasek, O.D.
- Optometrist
- Mount Vernon, MO
National Provider Identifier
1013939065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2371
- Practice address
- 600 N Main St
Mount Vernon, MO 65712-1004 - Phone
- (417) 466-0119
- Fax
- (417) 466-0126
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2371 | OK | Primary |
Addresses
Primary practice location
600 N Main St
Mount Vernon, MO 65712-1004
Mailing address
512 E Denton Cir
Republic, MO 65738-1368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northeastern State University College of Optometry | Optometrist | Past | Accepting new patients |
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.
-
- Optometrist
- Tahlequah, OK
- NPI 1437106333
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184630400000",
"number": "1013939065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 E DENTON CIR",
"city": "REPUBLIC",
"state": "MO",
"postal_code": "657381368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N MAIN ST",
"city": "MOUNT VERNON",
"state": "MO",
"postal_code": "657121004",
"telephone_number": "417-466-0119",
"fax_number": "417-466-0126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLASEK",
"first_name": "ANNE",
"middle_name": "FRANCES",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "OK",
"license": "2371",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Vernon, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.