Active NPI
Polly C Jones, PA-C
- Physician Assistant
- Hazard, KY
National Provider Identifier
1346243433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA392
- Practice address
- 145 Citizens LN
Suite B
Hazard, KY 41701-1320 - Phone
- (606) 439-1300
- Fax
- (606) 439-1400
- NPI assigned
- May 23, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA392 | KY | Primary |
Addresses
Primary practice location
145 Citizens LN
Suite B
Hazard, KY 41701-1320
Mailing address
PO Box 1988
Hazard, KY 41702-1988
Phone (606) 439-1300
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000588185 | Other | KY | ANTHEM BC/BS-HYDEN OFFICE |
| 000000588457 | Other | KY | ANTHEM BC/BS-VICCO OFFICE |
| 000000588455 | Other | KY | ANTHEM BC/BS-HAZARD OFFICE |
| 95000329 | Medicaid | KY |
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)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mitchell Wicker Jr MD PSC | Past | Accepting new patients | |
| Mitchell Wicker., Jr., M.D., P.S.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Hazard, KY
- NPI 1093718116
-
- Internal Medicine Physician
- Hazard, KY
- NPI 1629249560
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307577600000",
"number": "1346243433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1988",
"city": "HAZARD",
"state": "KY",
"postal_code": "417021988",
"telephone_number": "606-439-1300",
"fax_number": "606-439-1400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 CITIZENS LN",
"address_2": "SUITE B",
"city": "HAZARD",
"state": "KY",
"postal_code": "417011320",
"telephone_number": "606-439-1300",
"fax_number": "606-439-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "POLLY",
"middle_name": "C",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-23",
"last_updated": "2011-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA392",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS-HYDEN OFFICE",
"identifier": "000000588185",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS-VICCO OFFICE",
"identifier": "000000588457",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS-HAZARD OFFICE",
"identifier": "000000588455",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95000329",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hazard, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.