Individual provider Active NPI

Pamela B Polen, AUDIOLOGIST

  • Audiologist
  • Chattanooga, TN
National Provider Identifier
1285931774
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
262 Issued in TN
Practice address
6172 Airways Blvd
Suite 122
Chattanooga, TN 37421-2984
Phone
(423) 622-1551
NPI assigned
Feb 17, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 262 TN Primary

Addresses

Primary practice location

6172 Airways Blvd
Suite 122
Chattanooga, TN 37421-2984

Mailing address

3074 Hickory Valley Rd
Chattanooga, TN 37421-1265
Phone (423) 622-1551

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
262TNMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1297900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1285931774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3074 HICKORY VALLEY RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374211265",
            "telephone_number": "423-622-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6172 AIRWAYS BLVD",
            "address_2": "SUITE 122",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212984",
            "telephone_number": "423-622-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLEN",
        "first_name": "PAMELA",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "AUDIOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-17",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.