Suzann L Polk, APRN-BC

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

RN044136/APO199 Issued in AZ

Practice address

2940 Somerset Dr
Prescott, AZ 86305-5006

Phone

(928) 541-9024

NPI assigned

Sep 25, 2006

Sex

Female

Sole proprietor

Yes

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

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1164523098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 SOMERSET DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863055006",
            "telephone_number": "928-541-9024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 SOMERSET DR",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863055006",
            "telephone_number": "928-541-9024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "SUZANN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "APRN-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN044136/APO199",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AZ",
            "license": "RN044136/APO199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Renee Plaxton
• Richard Pleva, M.D.
• Elizabeth S Plummer, RN BC GNP
• Renee Podraza, MA, LPC, LISAC
• Kayla Renee Pokrzywinski, APRN, FNP-C
• Micaela Pommerening, PHARMD
• Mary M Poncel, M.D.
• Ponderosa Counseling of Arizona
• Ponderosa Pediatricss PLC
• Pool Therapy Plus, PLLC

• Gerontology Nurse Practitioner in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Gerontology Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2016; 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.