Organization Active NPI

William E Polley Jr Inc

  • Adult Day Care Clinic/Center
  • Fairlawn, OH
National Provider Identifier
1831378124
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
WILLIAM E POLLEY JR INC
Practice address
3094 W Market St
Fairlawn, OH 44333-3626
Phone
(330) 867-1205
Fax
(330) 867-1259
NPI assigned
Nov 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Dr. William E Polley Jr., MDNPI 1588683650
Title
Pres
Phone
(330) 867-1205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X Primary

Addresses

Primary practice location

3094 W Market St
Fairlawn, OH 44333-3626

Mailing address

3094 W Market St
Fairlawn, OH 44333-3626
Phone (330) 867-1205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120613000598 OH Part B Supplier - Clinic/Group Practice 2163442617 Receives reassigned benefits from 1 practitioner
Practice locations: Fairlawn, OH

National Provider Directory

National Provider Directory

Locations

2890 Sand Run Pkwy
Ste A
Fairlawn, OH 44333
Phone (330) 836-0135

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1831378124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3094 W MARKET ST",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333626",
            "telephone_number": "330-867-1205",
            "fax_number": "330-867-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3094 W MARKET ST",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443333626",
            "telephone_number": "330-867-1205",
            "fax_number": "330-867-1259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM E POLLEY JR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "POLLEY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "330-867-1205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; 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.