Tim Elden Poling, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4553 Issued in KS

Practice address

200 W Washington
Saint Francis, KS 67756-0867

Phone

(785) 332-3103

Fax

(785) 332-2289

NPI assigned

Jul 28, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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 KS

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

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1801800420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 867",
            "address_2": "200 W WASHINGTON",
            "city": "SAINT FRANCIS",
            "state": "KS",
            "postal_code": "677560867",
            "telephone_number": "785-332-3103",
            "fax_number": "785-332-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W WASHINGTON",
            "city": "SAINT FRANCIS",
            "state": "KS",
            "postal_code": "677560867",
            "telephone_number": "785-332-3103",
            "fax_number": "785-332-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLING",
        "first_name": "TIM",
        "middle_name": "ELDEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "4553",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chanda J Morris, CRNA
• Morrison Optometric Associates, PA (Vision Source of St Francis)
• Marlo Elizabeth Parsons, RN
• Brenda Peterson
• Brett Tyson Poling, D.C.
• Kristle E Raile, PA
• Tyler M Raile, PA
• Revive Performance & Rehab, LLC
• Kris Delynn Rice, LICENSED CLINICAL SO
• Jonathan Michael Riddell, PTA

• General Practice Dentistry in Saint Francis, KS
• Providers in Saint Francis, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.