Individual provider Active NPI

Christopher John Pollina, MD

  • Emergency Medicine Physician
  • Eden, NC
National Provider Identifier
1770511123
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
200300277 Issued in NC
Practice address
117 E Kings Hwy
Eden, NC 27288-5201
Phone
(336) 623-9711
Fax
(336) 623-7660
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 200300277 NC Primary

Addresses

Primary practice location

117 E Kings Hwy
Eden, NC 27288-5201

Mailing address

117 E Kings Hwy
Eden, NC 27288-5201
Phone (336) 623-9711

Other identifiers 2

IdentifierTypeStateIssuer
10180147MedicaidVA
891337NMedicaidNC

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050802000066 NC Practitioner - Emergency Medicine 7214965102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Pittsburgh School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Forest Emergency ProvidersGroup PAC ID 7012819816, 497 clinicians

Practice addresses (Care Compare)

1200 N Elm St
Greensboro, NC 27401-1004
Phone (336) 716-2255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Emergency Providers CurrentSince Sep 11, 2019 Accepting new patients
Morehead Memorial Hospital Emergency Medicine Past Accepting new patients
Emergency Medicine Physicians of Pasquotank County, PLLC Emergency Medicine Past Accepting new patients
Unc Rockingham Health Care, Inc. Past Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

557 Brookdale Dr
Statesville, NC 28677
Phone (330) 445-4361

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1770511123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E KINGS HWY",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885201",
            "telephone_number": "336-623-9711",
            "fax_number": "336-623-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 E KINGS HWY",
            "city": "EDEN",
            "state": "NC",
            "postal_code": "272885201",
            "telephone_number": "336-623-9711",
            "fax_number": "336-623-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLINA",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200300277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10180147",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891337N",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden, NC

Sources for this page

Verify at the official NPI Registry.