Dennis Polley, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

27881 Issued in NC

Practice address

1806 Glendale Dr SW
Wilson, NC 27893-4402

Phone

(252) 243-0566

Fax

(252) 243-1347

NPI assigned

Jul 21, 2006

Sex

Male

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 7

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Dermatology

Education

College of Medicine and Surgery, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Polley Clinic of Dermatology and Dermatologic SurgeryGroup PAC ID 9638134364, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ecu Health North Hospital Hospital, Roanoke Rapids, NC, CCN 340151

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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 and National Provider Directory roles.

• Polley Clinic of Dermatology & Dermatologic Surgery

  • Dermatopathology Physician
  • Wilson, NC
  • NPI 1104847714

  NC

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Halifax Regional Medical Center Inc

  • General Acute Care Hospital
  • Roanoke Rapids, NC
  • NPI 1346273943

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1649291394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 GLENDALE DR SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934402",
            "telephone_number": "252-243-0566",
            "fax_number": "252-243-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 GLENDALE DR SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934402",
            "telephone_number": "252-243-0566",
            "fax_number": "252-243-1347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLEY",
        "first_name": "DENNIS",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "27881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2222414",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "99494",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACCORDIA",
            "identifier": "68327",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7068303",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7257619",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "68327",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8968327",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James L. Pita
• Greta Vanbree Pittman
• Kimberly Bridgers Pittman
• Playful Pathways Learning & Development, LLC
• Polley Clinic of Dermatology & Dermatologic Surgery
• Elizabeth Pollock, MS, LCMHCA
• Alice Hall Pope
• Port Human Services
• Positive Life Styles
• Betty J Powell, CFTS

• All providers in Wilson, NC
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.