Individual provider Active NPI

Christina Polly, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Johnson City, TN
National Provider Identifier
1154816353
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
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

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.