Active NPI
Ernest Polley Jr.
- Licensed Practical Nurse
- Orlando, FL
National Provider Identifier
1053789982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN403501
- Practice address
- 1800 Mercy Dr
Orlando, FL 32808-5646 - Phone
- (407) 875-3700
- Fax
- (407) 659-0411
- NPI assigned
- Sep 9, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN403501 | FL | Primary |
Addresses
Primary practice location
1800 Mercy Dr
Orlando, FL 32808-5646
Mailing address
1800 Mercy Dr
Orlando, FL 32808-5646
Phone (407) 875-3700
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN403501 | FL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441756800000",
"number": "1053789982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 MERCY DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328085646",
"telephone_number": "407-875-3700",
"fax_number": "407-659-0411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 MERCY DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328085646",
"telephone_number": "407-875-3700",
"fax_number": "407-659-0411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLLEY",
"first_name": "ERNEST",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-09",
"last_updated": "2015-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "PN403501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.