John H Polak, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

31100 Issued in GA

Practice address

1350 Walton Way
Augusta, GA 30901-2612

Phone

(904) 805-1300

Fax

(904) 805-1302

NPI assigned

Jun 23, 2006

Sex

Male

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 4

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Umg Prompt Care LLC

  • Sports Medicine (Family Medicine) Physician
  • Grovetown, GA
  • NPI 1457759847
  NPD
• University Health Care Physicians LLC

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1568786192

  Emergency Medicine

  NPD
• University Medical Group LLC

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1871885806
  NPD
• University Prompt Care

  • Urgent Care Clinic/Center
  • Evans, GA
  • NPI 1326132788
  NPD
• Sterling Emergency Services of the Southeast Inc

  • Emergency Medicine Physician
  • Eatonton, GA
  • NPI 1992763627
  NPD (past)
• Uh Internal Medicine Partners

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1528010790
  NPD (past)
• University Medical Group LLC

  • Internal Medicine Physician
  • Augusta, GA
  • NPI 1336413954
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1508892407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 532780",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303532780",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012612",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLAK",
        "first_name": "JOHN",
        "middle_name": "H",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "31100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000403807C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "623872",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G31100",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTH CAROLINA MEDICAID",
            "identifier": "G31100",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonell B. Poe, PA
• Kathryn R Poehler, PA
• Randall M Pohjola, DDS
• Bernard Herman Pohlmann, DDS
• William Thad Poisson
• James B Polhill, PA-C
• Samantha Powell Pollock, RN
• Rosana Pon
• Sonali Ponkshe, MD
• Christlin Ponraj

• Emergency Medicine Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.