Richard I Polisner, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO1333 Issued in FL

Practice address

4621 Emerson St
Jacksonville, FL 32207-4920

Phone

(904) 994-0990

Fax

(904) 212-1373

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144352386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 ROSCOE BLVD N",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320822526",
            "telephone_number": "904-273-9384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 EMERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322074920",
            "telephone_number": "904-994-0990",
            "fax_number": "904-212-1373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLISNER",
        "first_name": "RICHARD",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO1333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shantell Polidor, APRN
• Adam J Polifka, MD
• Ryan David Poling, MD
• Taylor Poling
• Laura Beth Polinsky, PHARMD
• Kathrine Rose Polistina, ARNP
• Brandi Polite, APRN
• Leroy R. Polite, D.M.D.
• Christopher Polk, DC
• James Polk, M.A., CCC-SLP

• Foot & Ankle Surgery Podiatrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.