Brenda L. Polachek, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

134300 Issued in MO

Practice address

4201 N Belt Hwy
Saint Joseph, MO 64506-1299

Phone

(816) 749-4444

Fax

(816) 749-4446

NPI assigned

Apr 26, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1447577820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 N BELT HWY",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645061299",
            "telephone_number": "816-749-4444",
            "fax_number": "816-749-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 N BELT HWY",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645061299",
            "telephone_number": "816-749-4444",
            "fax_number": "816-749-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLACHEK",
        "first_name": "BRENDA",
        "middle_name": "L.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-26",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "134300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447577820",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200658140A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00847182",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pivotal Foot and Ankle Surgeons LLC
• Plastic Surgery Center of St Joseph, Inc
• Tara Ploeger, COTA
• Melissa Plum, DC
• Barbara Ann Poage, RPT
• Chester Pontius
• Steven Poplaw, MD
• Jeffrey Porter
• Audrey Postma, PA-C
• Potts Family Chiropractic PC

• Family Nurse Practitioner in Saint Joseph, MO
• Providers in Saint Joseph, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; 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.