Andrea Polk, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71006455A Issued in IN

Practice address

308 W Market St
Crawfordsville, IN 47933-1632

Phone

(765) 362-6374

Fax

(765) 362-6375

NPI assigned

Aug 12, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Franciscan Physician Network

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1225327984
  Medicare reassignment NPD
• Franciscan Physician Network

  dba Franciscan Immediate Care

  • Urgent Care Clinic/Center
  • Mishawaka, IN
  • NPI 1366879009
  NPD
• Franciscan Physician Network

  • Clinic/Center
  • Lafayette, IN
  • NPI 1992543250
  NPD

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720137600000",
    "number": "1518411073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 W MARKET ST",
            "city": "CRAWFORDSVILLE",
            "state": "IN",
            "postal_code": "479331632",
            "telephone_number": "765-362-6374",
            "fax_number": "765-362-6375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1165 N US Highway 421",
            "address_purpose": "LOCATION",
            "city": "Delphi",
            "state": "IN",
            "postal_code": "469238722",
            "country_code": "US",
            "telephone_number": "765-449-2732",
            "fax_number": "765-449-1196",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1640 Crawfordsville Square Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Crawfordsville",
            "state": "IN",
            "postal_code": "479333800",
            "country_code": "US",
            "telephone_number": "765-362-6374",
            "fax_number": "765-362-6375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLK",
        "first_name": "ANDREA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006455A",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71006455A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physiotherapy Associates Inc (Select Physical Therapy)
• Gregory T Pietz, O.D.
• Lauryn Pike, RBT
• Kenneth J. Pilcher, D.D.S.
• Pinnacle Dermatology, SC (Pinnacle Dermatology, Crawfordsville)
• Karyssa Potters, RBT
• Monika Poudel
• Pravin M Patel, MD Inc
• Kenneth Primm, M.D.
• Proactive Mso, LLC (Proactive MD)

• Family Nurse Practitioner in Crawfordsville, IN
• Providers in Crawfordsville, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.