Jennifer Theresa Poling, RN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

253912 Issued in SC

Practice address

700 21St Ave N
Myrtle Beach, SC 29577-7400

Phone

(843) 448-8407

NPI assigned

Mar 25, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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

• State of South Carolina Comptroller General

  • Skilled Nursing Facility
  • Florence, SC
  • NPI 1336994250
  NPD (past)

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1205463643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2072 BORGATA LOOP",
            "city": "LONGS",
            "state": "SC",
            "postal_code": "295685756",
            "telephone_number": "443-463-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 21ST AVE N",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295777400",
            "telephone_number": "843-448-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLING",
        "first_name": "JENNIFER",
        "middle_name": "THERESA",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "SC",
            "license": "253912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polaris Jack, Inc.
• Polaris Skin Diagnostics, LLC
• Polaya Anesthesia LLC
• Thomas Alan Polen, MD
• Vjekoslav Marko Polic, M.D.
• Taylor Harrison Polk, MD
• Misty Danelle Polston Whipkey, NP
• Linda R Pomeroy
• Desmond Recardo Ponder, MD
• Jacob Daniel Pope, D.O.

• Community Health Registered Nurse in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Community Health Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.