Jeffrey K Polzin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24022 Issued in WI

Practice address

610 W Adams St
Black River Falls, WI 54615-9010

Phone

(715) 284-4311

Fax

(715) 284-2568

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1205866191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W ADAMS ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546159010",
            "telephone_number": "715-284-4311",
            "fax_number": "715-284-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W ADAMS ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546159010",
            "telephone_number": "715-284-4311",
            "fax_number": "715-284-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLZIN",
        "first_name": "JEFFREY",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "24022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30384300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brenna Ann Peters, DNP
• Danielle Louise Peterson, DDS
• PFHN, LLC
• Pineview Nursing Home
• John Pleugers, M.A. LPC
• Patricia Popp, PTA
• Amy Prindle, P.A.
• Todd S Reich, D.D.S.
• Holly Kay Rodenberg, R.N., B.S.N
• Delbert W Rogers, M.D.

• Family Medicine Physician in Black River Falls, WI
• Providers in Black River Falls, WI by specialty
• Family Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.