Jason Polk

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2335 Issued in MS

Practice address

132 Riverview Dr Ste B
Flowood, MS 39232-8924

Phone

(601) 981-2707

NPI assigned

Nov 30, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Resilience Counseling & Recovery Center, LLC

  • Community/Behavioral Health Agency
  • Flowood, MS
  • NPI 1134467590
  NPD

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

{
    "created_epoch": "1543536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1831669043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 RIVERVIEW DR STE B",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328924",
            "telephone_number": "601-981-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 RIVERVIEW DR STE B",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328924",
            "telephone_number": "601-981-2707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "143 Hunt Cir",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "MS",
            "postal_code": "391108651",
            "country_code": "US",
            "telephone_number": "601-260-1691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POLK",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-30",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MS",
            "license": "2335",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MS",
            "license": "2335",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "2335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clayton Lowery Pitts, D.C.
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• Plastic Surgery Associates of Ms
• Plastic Surgical Center of Mississippi
• Noah Pogue, RN
• Shelby B Polk, DNP, APRN, FNP-BC
• Jamye Pollard, DNP, CRNA
• Mary Claire Ponder, APRN
• Mary Ellen Porter, NP
• Posterity Men'S Health, P.C.

• Professional Counselor in Flowood, MS
• Providers in Flowood, MS by specialty
• Professional Counselor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; 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.