Alyson Polanco

Primary specialty

ContractorTaxonomy code 171W00000X

License

006809 Issued in OH

Practice address

60 Brimley Dr
Fredericksburg, VA 22406-5148

Phone

(540) 552-6262

NPI assigned

Sep 26, 2007

Last updated

Jan 28, 2021By the provider in NPPES

Sex

Female

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

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1043407836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 GAUSE BLVD E",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704614223",
            "telephone_number": "985-781-4545",
            "fax_number": "317-449-5783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 BRIMLEY DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224065148",
            "telephone_number": "540-552-6262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "ALYSON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119006721",
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "OH",
            "license": "006809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randy Kathleen Plummer, RBT
• Kelly Leslie Poblacion, OTR/L
• Jashanda Poe
• Lina Poindexter, PHARMD
• Jason Dean Poirier, M.D.
• Shannon Polivka, COTA
• Laila Mackenzie Polk
• Traci Pomeroy, RBT
• Kaitlin Pond, P.A.
• Amy Charlene Pontarelli, RBT

• Contractor in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Contractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; 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.