Charles S Polley, MD
Individual provider Active NPI Emergency Medicine Physician · Cody, WY
NPI 1215028642 · NPPES record last updated Dec 4, 2025
Key facts
- NPI
- 1215028642
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 5435A (WY)
- Practice address
- 707 Sheridan Ave
Cody, WY 82414-3409 - Phone
- (307) 527-7501
- Fax
- (307) 578-2492
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 19
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- Texas a & M University System, HSC, College of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Billings Clinic
South Big Horn County Hospital District
Practice addresses (Care Compare)
201 Yellowstone Ave
Cody, WY 82414-9313
Phone (307) 527-7561
2800 10TH Ave N
Billings, MT 59101-0703
Phone (406) 657-4000
388 US Hwy 20 S
Basin, WY 82410-8902
Phone (307) 568-3311
Hospital & facility affiliations
- South Big Horn County Hospital
- Billings Clinic Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WY, MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101227000868 | WY | Practitioner - Emergency Medicine |
8123216660 | Reassigns benefits to 5 organizations |
| I20220708001491 | MT | Practitioner - Emergency Medicine | 8123216660 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104664 | MT | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital Association | Current |
Accepting new patients | |
| Billings Clinic | Current | Accepting new patients | |
| West Park Hospital District | Current |
Accepting new patients | |
| North Big Horn Hospital District | Current |
Accepting new patients | |
| South Big Horn County Hospital District | Current |
Accepting new patients | |
| Billings Clinic | Family Medicine | Current |
Accepting new patients |
| Memorial Hospital Association | Current |
Accepting new patients | |
| Billings Clinic | Emergency Medicine | Current | Accepting new patients |
| West Park Hospital District | Emergency Medicine | Current |
Accepting new patients |
| South Big Horn County Hospital District | Current |
Accepting new patients | |
| Billings Clinic | Current |
Accepting new patients | |
| North Big Horn Hospital | Current |
Accepting new patients | |
| Memorial Hospital Association | Current |
Accepting new patients | |
| South Big Horn County Hospital District | Current | Accepting new patients | |
| Billings Clinic | Family Medicine | Current |
Accepting new patients |
| Memorial Hospital Association | Past | Accepting new patients |
Locations
801 N 29th St
Billings, MT 59101
Phone (406) 238-2210
2800 10th Ave N
Billings, MT 59101
Phone (406) 248-3290
388 US Highway 20 S
Basin, WY 82410
Phone (307) 347-5810
707 Sheridan Ave
Cody, WY 82414
Phone (307) 527-7561
201 Yellowstone Ave
Cody, WY 82414
Phone (307) 527-7561
424 Yellowstone Ave
Ste 120
Cody, WY 82414
Phone (307) 578-2903
1115 Lane 12
Lovell, WY 82431
Phone (307) 548-2771
Interoperability endpoints
- cpolley1@billingsclinic.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 104664 | MT | |
| Emergency Medicine Physician | 207P00000X | 5435A | WY | Yes |
Addresses
Primary practice location
707 Sheridan Ave
Cody, WY 82414-3409
Mailing address
707 Sheridan Ave
Cody, WY 82414-3409
Phone (307) 527-7501
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 109873000 | Medicaid | WY | |
| 307422 | Other | WY | BCBS |
Other providers in Cody, WY
- Phoenix Rising Counseling, PC
- Laura Lou Pleban
- John David Poeverlein
- Glen Jeffrey Poffenbarger
- Scott Pollard
- Positive Spinn, LLC
- Irene Potter
- Neisha Potter
- Brooke Elizabeth Powell
- Molly Quaranto
All providers in Cody, WY · Emergency Medicine Physician in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.