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

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

Other identifiers 1

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

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.

• Humana at Home (TLC), Inc.

  • 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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY LICENSE",
            "identifier": "102239",
            "state": "TX"
        }
    ],
    "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": []
}

• Podiatric Medical Partners of Texas, PA
• 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.