Individual provider Active NPI

Caren M Polk, D.C.

  • Chiropractor
  • Cape Coral, FL
National Provider Identifier
1801969449
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7731 Issued in FL
Practice address
916 Cape Coral Pkwy E
Cape Coral, FL 33904-9014
Phone
(239) 542-1422
Fax
(239) 542-9688
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH7731 FL Primary

Addresses

Primary practice location

916 Cape Coral Pkwy E
Cape Coral, FL 33904-9014

Mailing address

916 Cape Coral Pkwy E
Cape Coral, FL 33904-9014
Phone (239) 542-1422

Other identifiers 1

IdentifierTypeStateIssuer
CH7731OtherFLLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801969449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 CAPE CORAL PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339049014",
            "telephone_number": "239-542-1422",
            "fax_number": "239-542-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 CAPE CORAL PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339049014",
            "telephone_number": "239-542-1422",
            "fax_number": "239-542-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "CAREN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "CH7731",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.