Jeni L Polk, APRN-CNP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

12176 Issued in WI

Practice address

1836 South Ave
La Crosse, WI 54601-5429

Phone

(608) 782-7300

NPI assigned

Oct 30, 2014

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeni.polk@direct.stjohnhealthsystem.com

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.

• Gundersen Lutheran Medical Center Inc

  dba Emplify Health Hamilton Clinic

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  NPD
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health East Building

  • Clinic/Center
  • La Crosse, WI
  • NPI 1497090138
  NPD
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health Onalaska Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567
  NPD
• Livea Medical PLLC

  • Obesity Medicine (Preventive Medicine) Physician
  • Coon Rapids, MN
  • NPI 1679386346
  NPD (past)

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1144625385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "JENI",
        "middle_name": "L",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-30",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "WI",
            "license": "12176",
            "primary": true
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "OK",
            "license": "R 0083094",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carleen M Poellinger, CNM
• Nancy J Pohlman
• Ashley Poirier
• Matthew Robert Poje
• Michael L Polito, DC
• Raymond D Pollock, MD
• Lynne Helen Polodna, FNP
• Laurie J Polubinsky, MD
• Sofia Rose Pomeroy
• Pomranke Inc

• Neonatal Nurse Practitioner in La Crosse, WI
• Providers in La Crosse, WI by specialty
• Neonatal Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.