Quaniqua Polk

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Practice address

601 Martin Luther King Jr. Dr.
432 FL Atkins Building
Winston-Salem, NC 27110

Phone

(336) 750-2000

NPI assigned

Mar 29, 2022

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1548910755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 GEORGE BIG REDD CT APT 202",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271012094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 MARTIN LUTHER KING JR. DR.",
            "address_2": "432 FL ATKINS BUILDING",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "27110",
            "telephone_number": "336-750-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "QUANIQUA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TENNESSEE",
            "identifier": "UKU909495074",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "601 Martin Luther King Jr. Dr.",
            "address_2": "432 FL Atkins Building",
            "city": "Winston-Salem",
            "state": "NC",
            "country_code": "US",
            "postal_code": "27110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephen Kenneth Polacek Jr.
• Thomas James Polascik, M.D.
• Jordan Matthew Poles, MD
• Gary Darneville Poleynard, MD
• Connor Gregory Policastro, MD
• Ricquanda Pollard
• Courtney Cash Pollock, PA-C
• Frank Edward Pollock Jr., M.D.
• Keri Olivia Pollock, DNP. APRN, AGAC-BC
• Philip Wade Ponder, M.D.

• Occupational Therapist in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.