Leif Andrew Polson, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

6549 Issued in NE

Practice address

110 E Arapahoe St
Thermopolis, WY 82443-2402

Phone

(307) 864-9411

NPI assigned

May 16, 2006

Sex

Male

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

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lpolson@hscmh.cernerdirect.com

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.

• Paintbrush Dental, PC

  • Dental Clinic/Center
  • Thermopolis, WY
  • NPI 1982932265
  NPD (past) Authorized official
• Hot Springs County Hospital District

  • Critical Access Hospital
  • Thermopolis, WY
  • NPI 1861550642
  NPD

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1790737005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ARAPAHOE ST",
            "city": "THERMOPOLIS",
            "state": "WY",
            "postal_code": "824432402",
            "telephone_number": "307-864-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E ARAPAHOE ST",
            "city": "THERMOPOLIS",
            "state": "WY",
            "postal_code": "824432402",
            "telephone_number": "307-864-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLSON",
        "first_name": "LEIF",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "6549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northwest Wyoming Boces
• Gary D Olheiser, OT
• Paintbrush Dental, PC
• Christopher H Paris, MS
• Physical Therapy Clinic PC
• Roger Pomeroy
• Leila H Porath, PT
• Thomas E Radosevich, M.D.
• Michael J Rawlings
• Red Rock Family Practice, Inc

• All providers in Thermopolis, WY
• Dentist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.