Organization Active NPI

Sarah Polk Nutrition

  • Registered Dietitian
  • Saint Louis, MO
National Provider Identifier
1467257709
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
SARAH POLK NUTRITION
Practice address
10004 Kennerly Rd Ste 370a
Saint Louis, MO 63128-5118
Phone
(314) 246-9072
Fax
(314) 627-7007
NPI assigned
Feb 18, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Sarah Elise Polk, RD, LD, CSOWMNPI 1528766581
Title
Registered Dietitian
Phone
(314) 246-9072

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X Primary

Addresses

Primary practice location

10004 Kennerly Rd Ste 370a
Saint Louis, MO 63128-5118

Mailing address

4134 Quincy St
Saint Louis, MO 63116-2705
Phone (636) 577-1686

Other practice location 1

4134 Quincy St
Saint Louis, MO 63116-2705
Phone (636) 577-1686

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250916004578 MO Part B Supplier - Clinic/Group Practice 9931603644 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1739836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1467257709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4134 QUINCY ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631162705",
            "telephone_number": "636-577-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 KENNERLY RD STE 370A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631285118",
            "telephone_number": "314-246-9072",
            "fax_number": "314-627-7007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4134 Quincy St",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631162705",
            "country_code": "US",
            "telephone_number": "636-577-1686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SARAH POLK NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ELISE",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "314-246-9072",
        "authorized_official_credential": "RD, LD, CSOWM"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.