JP Center for Plastic Surgery PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

4301403808 Issued in MI

Legal business name

JP CENTER FOR PLASTIC SURGERY PC

Practice address

3529 West Front St
JP Center for Plastic Surgery PC
Traverse City, MI 49684

Phone

(708) 203-6090

NPI assigned

May 13, 2014

Organization subpart

No

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

Authorized official

Name

Mr. John William Polley, M.D.

Title

President/Plastic Surgeon

Phone

(708) 203-6090

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1316358385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3529 WEST FRONT ST",
            "address_2": "JP CENTER FOR PLASTIC SURGERY PC",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "708-203-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3529 WEST FRONT ST",
            "address_2": "JP CENTER FOR PLASTIC SURGERY PC",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "708-203-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JP CENTER FOR PLASTIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-13",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "POLLEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT/PLASTIC SURGEON",
        "authorized_official_telephone_number": "708-203-6090",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "4301403808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Joseph
• Mary A Joslin, MSW
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• Joy Givers, Inc.
• Erica Joy
• Judith L Ramsdell, MD, PC
• Kasey Marie Juenke
• Julia Otwell LLC
• Katharine Julian, F.N.P.
• Bryan Jang Sup Jung, CMT

• Specialist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; 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.