Jeanna Suzanne Polonchek, ED.D, ATC, CPED, OT-

Primary specialty

SpecialistTaxonomy code 174400000X

License

248 Issued in MA

Practice address

1 Recovery Rd
Suite Four
Wareham, MA 02571-5011

Phone

(508) 295-8800

Fax

(508) 295-9467

NPI assigned

Mar 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Sole Remedy LLC

  • Durable Medical Equipment & Medical Supplies
  • New Bedford, MA
  • NPI 1114250552

  O20100930008027

  Same enrollment

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1790745693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 CRANE AVE S",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027807232",
            "telephone_number": "508-295-5100",
            "fax_number": "508-295-9467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RECOVERY RD",
            "address_2": "SUITE FOUR",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025715011",
            "telephone_number": "508-295-8800",
            "fax_number": "508-295-9467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLONCHEK",
        "first_name": "JEANNA",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "ED.D, ATC, CPED, OT-",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "5788400001",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne K Pinhancos, NP-C
• Christopher Joseph Pires Sr.
• Jodie Xavier Plouffe, P.A.
• Jessica Poeira
• Gabrielle Poekel, CD (DONA), BCPA
• Barbara J Pomeroy, RD
• Jennifer L Porter
• Allyson Preston, FNP
• Preventive Medicine Associates
• Lynsey Price, LICSW

• Specialist in Wareham, MA
• Providers in Wareham, MA by specialty
• Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.