Mark Mumford Polanshek, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

0101041167 Issued in VA

Practice address

4707 Buckingham CT
Chester, VA 23831-4261

Phone

(804) 796-2300

Fax

(804) 751-4815

NPI assigned

Mar 10, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Chester Pediatrics

  • Pediatric Adolescent Medicine Physician
  • Chester, VA
  • NPI 1649398462
  NPD (past)

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356473847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4707 BUCKINGHAM CT",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238314261",
            "telephone_number": "804-796-2300",
            "fax_number": "804-751-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 BUCKINGHAM CT",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238314261",
            "telephone_number": "804-796-2300",
            "fax_number": "804-751-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANSHEK",
        "first_name": "MARK",
        "middle_name": "MUMFORD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "VA",
            "license": "0101041167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6702481",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pillars of Care LLC
• Erin Pilling, DMD
• Pillpack LLC
• Kimberly Plummer
• Pmhealth Solutions, PLLC
• Zoe Politte
• Brian R Port, MD
• Positive Life Behavioral Health Services
• Positive Pathways Family Services
• Douglas C. Powell, D.O.

• Pediatric Adolescent Medicine Physician in Chester, VA
• Providers in Chester, VA by specialty
• Pediatric Adolescent Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.