Individual provider Active NPI

Nicole Ashley Polbos, ARNP

  • Primary Care Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1174063127
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
ARNP 9265534 Issued in FL
Practice address
6400 W Newberry Road
Suite 302
Gainesville, FL 32605
Phone
(352) 331-8902
Fax
(352) 224-1094
NPI assigned
Feb 24, 2017
Last updated
Sep 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X ARNP 9265534 FL Primary
Primary Care Nurse Practitioner 363LP2300X NP9265534 FL

Addresses

Primary practice location

6400 W Newberry Road
Suite 302
Gainesville, FL 32605

Mailing address

6400 W Newberry Road
Suite 302
Gainesville, FL 32605
Phone (352) 331-8902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20200122002413 FL Practitioner - Nurse Practitioner 9931534864 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Disease AssociatesGroup PAC ID 2365425816, 27 clinicians

Practice addresses (Care Compare)

6400 W Newberry Rd
Suite 308
Gainesville, FL 32605-6604

6400 W Newberry Rd
Suite 308
Gainesville, FL 32605-6609
Phone (352) 331-8902

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 9265534FLMDPrimary Care Nurse Practitioner
NP9265534FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease Associates CurrentSince Aug 1, 2025 Accepting new patients
Mohammad Ali Faisal, M.D., P.a. CurrentSince Jan 18, 2020 Accepting new patients
Mohammad Ali Faisal Mdpa Past Accepting new patients
Simedhealth LLC Past Accepting new patients

Locations

6400 W Newberry Rd
Ste 302
Gainesville, FL 32605
Phone (352) 331-8902

6400 W Newberry Rd
Ste 308
Gainesville, FL 32605
Phone (352) 331-8902

1283 SW State Road 47
Lake City, FL 32025
Phone (386) 758-5985

1283 SW State Road 47
Ste 104
Lake City, FL 32025
Phone (386) 758-5985

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1174063127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 W NEWBERRY ROAD",
            "address_2": "SUITE 302",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-331-8902",
            "fax_number": "352-224-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 W NEWBERRY ROAD",
            "address_2": "SUITE 302",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32605",
            "telephone_number": "352-331-8902",
            "fax_number": "352-224-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLBOS",
        "first_name": "NICOLE",
        "middle_name": "ASHLEY",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-24",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP 9265534",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "NP9265534",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.