Kristina Marie Polk, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

0101243992 Issued in VA

Practice address

100 Brewster Blvd
Emergency Medicine, DMS
Camp Lejeune, NC 28547

Phone

(910) 450-4053

NPI assigned

Mar 27, 2007

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 VA

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 Medicine

State licenses

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1598883324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "EMERGENCY MEDICINE DEPT",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "28547",
            "telephone_number": "910-450-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "address_2": "EMERGENCY MEDICINE, DMS",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "28547",
            "telephone_number": "910-450-4053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2080 Child St Emergency Medicine Department",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322142111",
            "country_code": "US",
            "telephone_number": "904-542-7345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 John Paul Jones Cir",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082111",
            "country_code": "US",
            "telephone_number": "757-953-1365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLK",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME130745",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101243992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Hansing Pilson, D.O.
• Amanda Pitcher, MD
• Donald Dwayne Pittman, USN IDC
• Taylor Clemmons Plumb, DO
• Douglas Michael Pokorny, D.O.
• David Michael Ponce Morado, MD
• Adel Catherine Ponder, AGNP, PMHNP
• Kathleen Poploski, DPT
• Christopher Juffan Galeos Porquiado, CRDH
• Gregory Potter

• Emergency Medicine Physician in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; 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.