Active NPI
Donna Darlene Polen, CNP
- Family Nurse Practitioner
- Marietta, OH
National Provider Identifier
1689709149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- COA.08621.NP
- Practice address
- 210 N 7TH St
Suite 101
Marietta, OH 45750-2244 - Phone
- (740) 376-0490
- Fax
- (740) 376-0438
- NPI assigned
- Feb 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | COA.08621.NP | OH | Primary |
Addresses
Primary practice location
210 N 7TH St
Suite 101
Marietta, OH 45750-2244
Mailing address
PO Box 449
Marietta, OH 45750-0449
Phone (740) 374-4500
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000733078 | Other | OH | ANTHEM |
| 3810018814 | Medicaid | WV | |
| P01207861 | Other | OH | RAILROAD MEDICARE |
| 000000680677 | Other | OH | ANTHEM |
| 2811201 | Medicaid | OH | |
| 000000699828 | Other | OH | ANTHEM |
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
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COA.08621.NP | OH | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381708800000",
"number": "1689709149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 449",
"city": "MARIETTA",
"state": "OH",
"postal_code": "457500449",
"telephone_number": "740-374-4500",
"fax_number": "740-374-5887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N 7TH ST",
"address_2": "SUITE 101",
"city": "MARIETTA",
"state": "OH",
"postal_code": "457502244",
"telephone_number": "740-376-0490",
"fax_number": "740-376-0438"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLEN",
"first_name": "DONNA",
"middle_name": "DARLENE",
"credential": "CNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2013-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "OH",
"license": "COA.08621.NP",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000733078",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810018814",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01207861",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000680677",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2811201",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000699828",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marietta, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.