Polly Duffus

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

10-2752GH Issued in FL

Practice address

4420 NW 23Rd St
Lauderhill, FL 33313-3521

Phone

(754) 214-3169

NPI assigned

Feb 3, 2022

Last updated

Feb 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

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.

• Ponkeys Home Care

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Lauderhill, FL
  • NPI 1528360799
  NPD (past) Authorized official

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1568116010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 NW 23RD ST",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333133521",
            "telephone_number": "754-214-3169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 NW 23RD ST",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333133521",
            "telephone_number": "754-214-3169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4710 NW 13th St",
            "address_purpose": "LOCATION",
            "city": "Lauderhill",
            "state": "FL",
            "postal_code": "333136532",
            "country_code": "US",
            "telephone_number": "754-214-3169",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUFFUS",
        "first_name": "POLLY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "FL",
            "license": "10-2752GH",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22444710",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Lauderhill",
            "affiliation": "N",
            "endpointDescription": "communication",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "communication",
            "address_1": "4420 NW 23rd St",
            "city": "Lauderhill",
            "state": "FL",
            "country_code": "US",
            "postal_code": "333133521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dr. Henry N Merritt Jr PA
• Dr. Raquel KS Moncrieffe & Assoc., Inc.
• Jason Duarte
• Yucely Duboy
• Shareeka Monick Dubreus
• Guerzby Dumerve, SA-C
• Colis Duncan
• Jennifer Dupoux
• Max Dupoux, LIC. AP
• Shana Durham, PHARMD, CPH

• Developmentally Disabled Services Day Training Agency in Lauderhill, FL
• Providers in Lauderhill, FL by specialty
• Developmentally Disabled Services Day Training Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.