Individual provider Active NPI

Nicole Noel Polakowski, PT

  • Physical Therapist
  • Hancock, MI
National Provider Identifier
1265703292
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
L2062943 Issued in MI
Practice address
1400 Poplar St
Hancock, MI 49930-1121
Phone
(906) 482-6644
Fax
(906) 483-0154
NPI assigned
Jan 23, 2012
Last updated
Jan 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X L2062943 MI Primary

Addresses

Primary practice location

1400 Poplar St
Hancock, MI 49930-1121

Mailing address

1400 Poplar St
Hancock, MI 49930
Phone (906) 482-6644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
L2062943MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1265703292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 POPLAR ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "49930",
            "telephone_number": "906-482-6644",
            "fax_number": "906-483-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 POPLAR ST",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301121",
            "telephone_number": "906-482-6644",
            "fax_number": "906-483-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAKOWSKI",
        "first_name": "NICOLE",
        "middle_name": "NOEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-23",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "L2062943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hancock, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2012; 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.