Active NPI
Hiram C Polk Jr., MD
- Surgical Oncology Physician
- Louisville, KY
National Provider Identifier
1841260841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Oncology Physician
- License
- 15978
- Practice address
- 401 E Chestnut St
Suite 710
Louisville, KY 40202-5700 - Phone
- (502) 583-8303
- Fax
- (502) 584-0302
- NPI assigned
- Jan 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 15978 | KY | |
| Surgical Oncology Physician | 2086X0206X | 15978 | KY | Primary |
Addresses
Primary practice location
401 E Chestnut St
Suite 710
Louisville, KY 40202-5700
Mailing address
401 E Chestnut St
Suite 710
Louisville, KY 40202-5700
Phone (502) 583-8303
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1054329 | Other | KY | PASSPORT |
| 64159783 | Medicaid | KY | |
| 100348380A | Medicaid | IN |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15978 | KY | MD | Surgical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Physicians Group - Radiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- Louisville, KY
- NPI 1619061116
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248912000000",
"number": "1841260841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 E CHESTNUT ST",
"address_2": "SUITE 710",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402025700",
"telephone_number": "502-583-8303",
"fax_number": "502-584-0302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 E CHESTNUT ST",
"address_2": "SUITE 710",
"city": "LOUISVILLE",
"state": "KY",
"postal_code": "402025700",
"telephone_number": "502-583-8303",
"fax_number": "502-584-0302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLK",
"first_name": "HIRAM",
"middle_name": "C",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2009-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "KY",
"license": "15978",
"primary": false
},
{
"code": "2086X0206X",
"taxonomy_group": "",
"desc": "Surgery, Surgical Oncology",
"state": "KY",
"license": "15978",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT",
"identifier": "1054329",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64159783",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100348380A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.