Polly Jane Boone

Primary specialty

Social WorkerTaxonomy code 104100000X

License

0904011171 Issued in VA

Practice address

3003 Hollins Rd NE
Roanoke, VA 24012-7505

Phone

(540) 344-6208

Fax

(540) 344-9112

NPI assigned

Sep 24, 2019

Last updated

Sep 24, 2019By 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blue Ridge Behavioral Healthcare

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roanoke, VA
  • NPI 1437137734
  NPD

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1710538574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 HOLLINS RD NE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240127505",
            "telephone_number": "540-344-6208",
            "fax_number": "540-344-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 HOLLINS RD NE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240127505",
            "telephone_number": "540-344-6208",
            "fax_number": "540-344-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "POLLY",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VA",
            "license": "0904011171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene A. Bondarev, M.D.
• Lisa Jane Booan, M.ED, ED.S.
• Cheryl Pring Boone, PHARMACIST
• John A Boone, DO
• Margaret Boone, LPTA
• Toni Boone
• Boothe Family Vision Care
• Kari Harner Boothe, O.D.
• Buli Borah, FNP-BC
• Jonathan Boring, D.O.

• Social Worker in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.