Organization Active NPI

Cheryl a Polly L P C PC

  • Counselor
  • Wichita Falls, TX
National Provider Identifier
1184498669
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
CHERYL A POLLY L P C PC
Practice address
909 8TH St Ste 300
Wichita Falls, TX 76301-6820
Phone
(940) 767-2914
Fax
(866) 838-5630
NPI assigned
Nov 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Authorized official

Name
Cheryl PollyNPI 1194777896
Title
Provider
Phone
(940) 767-2914

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X Primary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X

Addresses

Primary practice location

909 8TH St Ste 300
Wichita Falls, TX 76301-6820

Mailing address

909 8TH St Ste 300
Wichita Falls, TX 76301-6820
Phone (940) 767-2914

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231211000694 TX Part B Supplier - Clinic/Group Practice 1658720008 Receives reassigned benefits from 1 practitioner
Practice locations: Wichita Falls, TX

National Provider Directory

National Provider Directory

Locations

909 8th St
Ste 300
Wichita Falls, TX 76301
Phone (940) 767-2914

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1699920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700179200000",
    "number": "1184498669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 8TH ST STE 300",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763016820",
            "telephone_number": "940-767-2914",
            "fax_number": "866-838-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 8TH ST STE 300",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763016820",
            "telephone_number": "940-767-2914",
            "fax_number": "866-838-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERYL A POLLY L P C PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-14",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A",
        "authorized_official_last_name": "POLLY",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "940-767-2914"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.