Individual provider Active NPI

Casey Deanne Polk, APRN, AGACNP-BC

  • Gerontology Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1467235069
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1131805 Issued in TX
Practice address
5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-7200
Phone
(214) 648-3111
NPI assigned
Aug 16, 2023
Last updated
Dec 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 1131805 TX Primary
Acute Care Nurse Practitioner 363LA2100X 1131805 TX

Addresses

Primary practice location

5323 Harry Hines Blvd Stop 7200
Dallas, TX 75390-7200

Mailing address

7032 Cedar Creek Dr
Grand Prairie, TX 75052-1371
Phone (601) 951-2252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20241013000204 TX Practitioner - Nurse Practitioner 0345772547 Reassigns benefits to 1 organization

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

Practice addresses (Care Compare)

6201 Harry Hines Blvd
Dallas, TX 75390-9032
Phone (214) 633-5555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1131805TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 26, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jul 26, 2024 Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

6201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 633-4700

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 3

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": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1467235069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7032 CEDAR CREEK DR",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521371",
            "telephone_number": "601-951-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD STOP 7200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907200",
            "telephone_number": "214-648-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "CASEY",
        "middle_name": "DEANNE",
        "credential": "APRN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1131805",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1131805",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.