Angel Dyke Polivka, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

890 N 200 W
Pleasant Grove, UT 84062-1608

Phone

(812) 219-7233

NPI assigned

Jan 29, 2022

Last updated

Jan 29, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1643414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643414400000",
    "number": "1679226724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 N 200 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840621608",
            "telephone_number": "812-219-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 N 200 W",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840621608",
            "telephone_number": "812-219-7233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKE POLIVKA",
        "first_name": "ANGEL",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-29",
        "last_updated": "2022-01-29",
        "certification_date": "2022-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Downs
• Sean Cameron Doyle, D.O.
• Taylor Mae Drew
• Sadie Durham
• Dustin B. Wise, M.D., P.C. (Lone Peak Pediatrics)
• Dynamic Health Care of Utah LLC (Lowry Health & Wellness)
• Echo Ultrasound LLC
• Eddie Faddis, DDS, PC
• Trent Edwards
• William Foster Edwards, M.D.

• Speech-Language Pathologist in Pleasant Grove, UT
• Providers in Pleasant Grove, UT by specialty
• Speech-Language Pathologist in Utah

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