Stacey Pollom

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

27095 Issued in TN

Practice address

300 Cherokee Blvd Ste 110
Chattanooga, TN 37405-4467

Phone

(423) 326-7658

NPI assigned

Apr 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1306379631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 ALABAMA AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374091708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CHEROKEE BLVD STE 110",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374054467",
            "telephone_number": "423-326-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOM",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-04",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95104604",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "27095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela B Polen, AUDIOLOGIST
• Jack C Pollard, D.C.
• Natalie Jane Pollard, FNP
• Theresa A. Pollard, MD
• Philip G Pollock, MD
• Pomerance Eye Center, PC
• Pomerance Eye Center, PC
• Glenn Noel Pomerance, M.D.
• Zachary Pomerleau
• Jaime Ponce-Portugal, MD

• Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.