Fallon N Polich

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

202110122NP-PP Issued in OR

Practice address

590 Allison St
Ashland, OR 97520-2910

Phone

(406) 868-6458

NPI assigned

Aug 27, 2021

Last updated

Nov 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Medicare reassignment NPD
• Grande Ronde Hospital, Inc.

  • Critical Access Hospital
  • La Grande, OR
  • NPI 1467446195
  Medicare reassignment NPD
• Icco, LLC

  dba BestMed

  • Urgent Care Clinic/Center
  • Eugene, OR
  • NPI 1407004757
  Medicare reassignment NPD
• Asante

  dba Heimann Cancer Center

  • Specialty Pharmacy
  • Medford, OR
  • NPI 1699426684
  NPD
• Grande Ronde Hospital, Inc.

  dba Grande Ronde Hospital Urgent Care

  • Rural Health Clinic/Center
  • La Grande, OR
  • NPI 1093296519
  NPD
• Icco LLC

  dba BestMed

  • Rural Health Clinic/Center
  • Florence, OR
  • NPI 1740896547
  NPD
• Icco, LLC

  dba BestMed

  • Family Medicine Physician
  • Eugene, OR
  • NPI 1992861611
  NPD
• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1124158647
  NPD (past)

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1386311157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 ALLISON ST",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202910",
            "telephone_number": "406-868-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 ALLISON ST",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202910",
            "telephone_number": "406-868-6458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2825 E Barnett Rd",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975048332",
            "country_code": "US",
            "telephone_number": "541-789-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLICH",
        "first_name": "FALLON",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "202110122NP-PP",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201909188RN",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Planned Parenthood of Southwestern Oregon
• Planned Parenthood of Southwestern Oregon
• Judith Platt, L.AC.
• Joanna Poague
• Gina Renae Polansky
• Erin Pollinger, D.C.
• Lauren Pollock
• Positive Behavior Advisor
• Potential Unlimited (ADD/ADHD Clinic)
• Carolyn J Potts Metzker, LPC

• Family Nurse Practitioner in Ashland, OR
• Providers in Ashland, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; 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.