Teresa Polk, CFNP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R694061 Issued in MS

Practice address

811 Highway 49 South
Richland, MS 39218

Phone

(601) 932-5060

Fax

(601) 932-5062

NPI assigned

Aug 22, 2008

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9272/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dra Health Services LLC

  • Early Intervention Provider Agency
  • Madison, MS
  • NPI 1982902797
  NPD (past)
• East Metro Family Medical Clinic

  • Ph.D. Medical Genetics
  • Richland, MS
  • NPI 1750447926
  NPD (past)
• Jackson Cardiology Associates, P.a.

  • Cardiovascular Disease Physician
  • Jackson, MS
  • NPI 1851305429
  NPD (past)

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1487801338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 180165",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "39218",
            "telephone_number": "601-932-5060",
            "fax_number": "601-932-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 HIGHWAY 49 SOUTH",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "39218",
            "telephone_number": "601-932-5060",
            "fax_number": "601-932-5062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "TERESA",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "R694061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00117759",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaycee Sue Pilcher
• Polk Dental Center
• James D Polk, M.D.
• Jason L Polk, D. M. D
• Lexi A. Polk, D.M.D
• Polk'S Crossgate Discount Drugs Inc.
• James Anthony Presley, DMD,FAGD
• Chad L Propst, PTA
• Quad Intermed Company LLC
• Cari A Ray, SLP

• All providers in Richland, MS
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; 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.