Andrea Marie Polk, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F0710391 Issued in IN

Practice address

109 US Highway 66 E
Tell City, IN 47586-2755

Phone

(812) 547-3447

Fax

(812) 547-9543

NPI assigned

Oct 14, 2010

Last updated

Oct 14, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Andrea Marie Bruggeman Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Perry County Memorial HospitalGroup PAC ID 6901871276, 28 clinicians

Perry County Family PracticeGroup PAC ID 6204867559, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Perry County Memorial Hospital Hospital, Tell City, IN, CCN 151322

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrea.polk.1@21400.direct.athenahealth.com

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.

• Perry County Memorial Hospital

  dba Leopold Clinic

  • Rural Health Clinic/Center
  • Leopold, IN
  • NPI 1215928536

  Family

  Medicare reassignment Care Compare group NPD
• Perry County Memorial Hospital

  dba PCMH Provider Clinics

  • General Practice Physician
  • Tell City, IN
  • NPI 1629621396

  Family

  Medicare reassignment Care Compare group NPD
• Perry County Memorial Hospital

  dba Main Street Clinic

  • Nurse Practitioner
  • Tell City, IN
  • NPI 1740151489
  NPD
• Perry County Memorial Hospital

  dba PCMH Wound Care Center

  • Critical Access Hospital
  • Tell City, IN
  • NPI 1447206248

  Family

  NPD (past)

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

• Perry County Memorial Hospital

  • Ambulance
  • Tell City, IN
  • NPI 1356309777

  Hospital

  Care Compare affiliation
• Perry County Memorial Hospital

  • Critical Access Hospital
  • Tell City, IN
  • NPI 1699779017
  Care Compare affiliation

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287014400000",
    "number": "1427368208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 US HIGHWAY 66 E",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "475862755",
            "telephone_number": "812-547-3447",
            "fax_number": "812-547-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 US HIGHWAY 66 E",
            "city": "TELL CITY",
            "state": "IN",
            "postal_code": "475862755",
            "telephone_number": "812-547-3447",
            "fax_number": "812-547-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-14",
        "last_updated": "2010-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F0710391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BRUGGEMAN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Perry County OB/GYN
• Perry County Radiological Associates,LLC
• Perry Regional Foot & Ankle, PSC
• Baylie Madison Peter, MSOT, OTR
• Layla Jane Piper, MSW, LSW
• Samantha K Polk, FNP-C
• Joshua David Poos, M.D.
• Sidney Ann Raetz, FNP-C
• Amanda Rae Ramsey
• Don A Ray, CRNA

• Family Nurse Practitioner in Tell City, IN
• Providers in Tell City, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.