Individual provider Active NPI

Lauren Kimberly Poling, D.O.

  • Internal Medicine Physician
  • Glendale, AZ
National Provider Identifier
1336501170
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
007955 Issued in AZ
Practice address
4319 W Bell Rd
Glendale, AZ 85308-3530
Phone
(602) 888-0448
Fax
(415) 252-7176
NPI assigned
Mar 22, 2016
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 007955 AZ Primary

Addresses

Primary practice location

4319 W Bell Rd
Glendale, AZ 85308-3530

Mailing address

4319 W Bell Rd
Glendale, AZ 85308-3530
Phone (602) 888-0448

Other names 1

  • Dr. Lauren Kimberly Bacon Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190920000137 AZ Practitioner - Internal Medicine 4688904451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iora Senior Health LLCGroup PAC ID 0143520189, 117 clinicians

Practice addresses (Care Compare)

3137 W Indian School Rd
Phoenix, AZ 85017-4069
Phone (888) 405-6396

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
007955AZMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iora Senior Health, LLC Internal Medicine Current Accepting new patients
Iora Senior Health, LLC Internal Medicine CurrentSince Sep 9, 2019 Accepting new patients
Iora Senior Health, LLC Internal Medicine CurrentSince Sep 9, 2019 Accepting new patients
Iora Health, LLC Internal Medicine Past Accepting new patients
Iora Health Massachusetts, P.C. Internal Medicine Past Accepting new patients
Iora Senior Health, LLC Internal Medicine Past Accepting new patients

Locations

4319 W Bell Rd
Glendale, AZ 85308
Phone (602) 888-0448

4319 W Bell Rd
Ste 4319
Glendale, AZ 85308
Phone (602) 888-0448

3137 W Indian School Rd
Phoenix, AZ 85017
Phone (602) 325-5570

101 Tremont St
Fl 6
Boston, MA 02108

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1336501170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 W BELL RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083530",
            "telephone_number": "602-888-0448",
            "fax_number": "415-252-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 W BELL RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083530",
            "telephone_number": "602-888-0448",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLING",
        "first_name": "LAUREN",
        "middle_name": "KIMBERLY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "007955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "BACON",
            "middle_name": "KIMBERLY",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.