Individual provider Active NPI

Ginny Marie Polm, APRN

  • Family Nurse Practitioner
  • Drumright, OK
National Provider Identifier
1407612757
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
216802 Issued in OK
Practice address
610 W Bypass
Drumright, OK 74030-5957
Phone
(918) 382-2300
NPI assigned
Feb 26, 2024
Last updated
Mar 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 216802 OK Primary

Addresses

Primary practice location

610 W Bypass
Drumright, OK 74030-5957

Mailing address

610 W Bypass
Drumright, OK 74030-5957

Other names 1

  • Ginny Marie Riise Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20240410001882 OK Practitioner - Nurse Practitioner 8325486228 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Drumright Community Hospital LLCGroup PAC ID 9335570985, shared by 4 NPIs, 14 clinicians
Cah Acquisition Company 4, IncGroup PAC ID 9830242031, 5 clinicians

Practice addresses (Care Compare)

610 W Bypass
Drumright, OK 74030-5957
Phone (918) 382-2300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
216802OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Drumright Community Hospital LLC Current Accepting new patients
Drumright Community Hospital LLC CurrentSince Apr 1, 2024 Accepting new patients
Cah Acquisition Company 4 Inc Past Accepting new patients

Locations

610 W Bypass
Drumright, OK 74030
Phone (918) 382-2300

612 W Bypass
Drumright, OK 74030
Phone (918) 382-5955

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1407612757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W BYPASS",
            "city": "DRUMRIGHT",
            "state": "OK",
            "postal_code": "740305957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W BYPASS",
            "city": "DRUMRIGHT",
            "state": "OK",
            "postal_code": "740305957",
            "telephone_number": "918-382-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLM",
        "first_name": "GINNY",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "216802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINNY",
            "last_name": "RIISE",
            "middle_name": "MARIE",
            "credential": "APRN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Drumright, OK

Sources for this page

Verify at the official NPI Registry.