Active NPI
Gina Renae Polansky
- Physical Therapist
- Ashland, OR
National Provider Identifier
1598872525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 370 E Hersey St Ste 1
Ashland, OR 97520-2325 - Phone
- (541) 482-6360
- NPI assigned
- Aug 24, 2006
- Last updated
- Aug 8, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
370 E Hersey St Ste 1
Ashland, OR 97520-2325
Mailing address
504 Keene Dr
Medford, OR 97504-8027
Phone (970) 219-2459
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8666 | Other | CO | LICENSE # |
| 60382 | Other | OR | STATE OF OREGON PHYSICAL THERAPY LICENSING BOARD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407456000000",
"number": "1598872525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 KEENE DR",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048027",
"telephone_number": "970-219-2459"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "370 E HERSEY ST STE 1",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975202325",
"telephone_number": "541-482-6360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLANSKY",
"first_name": "GINA",
"middle_name": "RENAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2014-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "8666",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF OREGON PHYSICAL THERAPY LICENSING BOARD",
"identifier": "60382",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.