Individual provider Active NPI

Jessica Poba Polo, NP

  • Family Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1417760976
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5021579 Issued in NC
Practice address
3320 Wake Forest Rd Ste 450
Raleigh, NC 27609-7300
Phone
(919) 790-1717
Fax
(800) 589-7011
NPI assigned
Jan 29, 2025
Last updated
Jan 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 306939 NC
Family Nurse Practitioner 363LF0000X 5021579 NC Primary

Addresses

Primary practice location

3320 Wake Forest Rd Ste 450
Raleigh, NC 27609-7300

Mailing address

3320 Wake Forest Rd Ste 450
Raleigh, NC 27609-7300
Phone (919) 790-1717

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250410001060 NC Practitioner - Nurse Practitioner 2860916947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivx Health of North Carolina P.C.Group PAC ID 2264812866, 21 clinicians

Practice addresses (Care Compare)

7901 Falls of Neuse Rd
Suite 105109
Raleigh, NC 27615-3347
Phone (919) 913-8757

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306939NCMDRegistered Nurse
5021579NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ivx Health of North Carolina, P.C. CurrentSince Mar 3, 2025 Accepting new patients
Hey Clinic, PA PastSince Oct 19, 2020 Accepting new patients

Locations

9200 Harris Corners Pkwy
Ste A
Charlotte, NC 28269
Phone (704) 342-9011

4205 W Wendover Ave
Ste D
Greensboro, NC 27407
Phone (336) 510-2625

7901 Falls of Neuse Rd
Ste 105
Raleigh, NC 27615
Phone (919) 913-8757

7901 Falls of Neuse Rd
Ste 105109
Raleigh, NC 27615
Phone (919) 913-8757

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

NPI Registry JSON

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767916800000",
    "number": "1417760976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 WAKE FOREST RD STE 450",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097300",
            "telephone_number": "919-790-1717",
            "fax_number": "800-589-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 WAKE FOREST RD STE 450",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276097300",
            "telephone_number": "919-790-1717",
            "fax_number": "800-589-7011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLO",
        "first_name": "JESSICA",
        "middle_name": "POBA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-29",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "306939",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5021579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.