Active NPI
Christina Polly, M.S., CCC-SLP
- Speech-Language Pathologist
- Johnson City, TN
National Provider Identifier
1154816353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Practice address
- 2012 Sherwood Dr
Johnson City, TN 37601-3238 - Phone
- (877) 584-3412
- NPI assigned
- Jun 29, 2018
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
2012 Sherwood Dr
Johnson City, TN 37601-3238
Mailing address
1503 E 11TH Ave
Johnson City, TN 37601-2720
Phone (606) 733-5400
Other practice location 1
2300 Pavilion Dr
Kingsport, TN 37660-4622
Phone (423) 765-9655
Other practice location 2
113 Cassell Dr
Kingsport, TN 37660-3775
Phone (423) 246-7240
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
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1530230400000",
"number": "1154816353",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1503 E 11TH AVE",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376012720",
"telephone_number": "606-733-5400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2012 SHERWOOD DR",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376013238",
"telephone_number": "877-584-3412"
}
],
"practiceLocations": [
{
"address_1": "2300 Pavilion Dr",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376604622",
"country_code": "US",
"telephone_number": "423-765-9655",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "113 Cassell Dr",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376603775",
"country_code": "US",
"telephone_number": "423-246-7240",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "POLLY",
"first_name": "CHRISTINA",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-29",
"last_updated": "2018-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.