Active NPI
Polina Kodess
- Psychologist
- Denver, CO
National Provider Identifier
1194395129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY0004841
- Practice address
- 4495 Hale Pkwy Ste 110
Denver, CO 80220-6203 - Phone
- (970) 556-8681
- NPI assigned
- Jun 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY0004841 | CO | Primary |
Addresses
Primary practice location
4495 Hale Pkwy Ste 110
Denver, CO 80220-6203
Mailing address
4495 Hale Pkwy Ste 110
Denver, CO 80220-6203
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY0004841 | CO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1194395129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4495 HALE PKWY STE 110",
"city": "DENVER",
"state": "CO",
"postal_code": "802206203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4495 HALE PKWY STE 110",
"city": "DENVER",
"state": "CO",
"postal_code": "802206203",
"telephone_number": "970-556-8681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KODESS",
"first_name": "POLINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-30",
"last_updated": "2021-06-30",
"certification_date": "2021-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CO",
"license": "PSY0004841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.