Andrea Polk, CPHT

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

License

1124201215 Issued in TX

Practice address

2001 W John Carpenter Fwy
Irving, TX 75063-3255

Phone

(800) 379-0092

NPI assigned

May 11, 2022

Last updated

May 11, 2022By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: apolk@humana.com

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

• Humana at Home (TLC), Inc.

  dba SeniorBridge

  • Home Health Agency
  • Irving, TX
  • NPI 1124201215
  NPD (past)

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

{
    "created_epoch": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1255077293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 ST CHARLES CT",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760131370",
            "telephone_number": "469-401-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W JOHN CARPENTER FWY",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750633255",
            "telephone_number": "800-379-0092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9843 Windisch Rd",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "OH",
            "postal_code": "450693826",
            "country_code": "US",
            "telephone_number": "888-431-4748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLK",
        "first_name": "ANDREA",
        "credential": "CPHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "TX",
            "license": "1124201215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apolk@humana.com",
            "affiliation": "Y",
            "endpointDescription": "Mail order",
            "affiliationName": "Humana At Home (TLC), Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2001 W John Carpenter Fwy Ste 142",
            "city": "Irving",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750633255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marisa Victoria Podolak, FNP-BC
• Kathryn Ann Poe, M.A., LPC
• Yin Nyein Poe
• Polestar Medical
• Laura Polis
• Daniel Polk Jr., RRT
• Delara Pollman, APRN-CNP
• Amy Beth Poole, M.S. CCC-SLP
• Darci Marie Porter, L.P.C.
• Elizabeth Ann Porter, ARNP

• Clinic Pharmacy in Irving, TX
• Providers in Irving, TX by specialty
• Clinic Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.