Active NPI
Pretti Lane Polk, CNP
- Nurse Practitioner
- Akron, OH
National Provider Identifier
1154717437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- COA.16789-NP
- Practice address
- 1 Perkins SQ
Akron, OH 44308-1063 - Phone
- (330) 543-8050
- Fax
- (330) 543-8054
- NPI assigned
- Apr 13, 2015
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | COA.16789-NP | OH | Primary |
Addresses
Primary practice location
1 Perkins SQ
Akron, OH 44308-1063
Mailing address
1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 543-8050
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ppolk44831@direct.chmca.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.16789-NP | OH | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Youth Advocate Program, Inc | Current | Accepting new patients | |
| Children'S Hospital Medical Center of Akron | Current | Accepting new patients | |
| Children'S Hospital Medical Center of Akron | Current | Accepting new patients | |
| Children'S Hospital Medical Center of Akron | Current | Accepting new patients | |
| National Youth Advocate Program, Inc | Current | Accepting new patients |
Locations
1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050
5500 S Marginal Rd
Ste 220
Cleveland, OH 44103
Phone (216) 221-7588
527 S High St
Columbus, OH 43215
Phone (614) 227-9444
1801 Watermark Dr
Ste 200
Columbus, OH 43215
Organizations & group practices 5
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.
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-
- Home Infusion Agency
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-
- Mental Health Clinic/Center (Including Community Mental Health Center)
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1617753600000",
"number": "1154717437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PERKINS SQ",
"city": "AKRON",
"state": "OH",
"postal_code": "443081063",
"telephone_number": "330-543-8050",
"fax_number": "330-543-8054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PERKINS SQ",
"city": "AKRON",
"state": "OH",
"postal_code": "443081063",
"telephone_number": "330-543-8050",
"fax_number": "330-543-8054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLK",
"first_name": "PRETTI",
"middle_name": "LANE",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-13",
"last_updated": "2021-04-07",
"certification_date": "2021-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "COA.16789-NP",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ppolk44831@direct.chmca.org",
"affiliation": "N",
"address_1": "1 Perkins Sq",
"city": "Akron",
"state": "OH",
"country_code": "US",
"postal_code": "443081063",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; 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.