Jorge Polanco, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

200201300 Issued in NC

Practice address

262 Leroy George Dr
Clyde, NC 28721-7430

Phone

(843) 237-3378

Fax

(843) 237-5073

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Cogent Healthcare of North Carolina, PC

  • Internal Medicine Physician
  • Rocky Mount, NC
  • NPI 1548207483

  Internal Medicine, NC

  Medicare reassignment NPD
• Hospitalist Medicine Physicians of North Carolina PLLC

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1164724902

  Internal Medicine, NC

  Medicare reassignment NPD

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237248000000",
    "number": "1346211455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60274",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600274",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 LEROY GEORGE DR",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287217430",
            "telephone_number": "843-237-3378",
            "fax_number": "843-237-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "JORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2009-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200201300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891323K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1323K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00201238",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David William Peterson, M.D.
• Ditte Gail Phillips, MD
• Jessica Smith Pior, MD
• Julia Cooke Plemmons, MN,WHNP,FNP
• Eva Janice Plott, FNP
• Christopher Brent Porter, MD
• Prime Doc of Haywood, PA
• Radiation Therapy Associates of Western North Carolina PA
• Natalie Colette Ralph, D.O.
• Ramellini Associates, P.C.

• Internal Medicine Physician in Clyde, NC
• Providers in Clyde, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.