Mary Lou Polchek, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA0000001871 Issued in TN

Practice address

1101 Forest Harbor Dr
Hendersonville, TN 37075-9645

Phone

(615) 264-1342

Fax

(615) 431-0449

NPI assigned

Aug 6, 2010

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281052800000",
    "number": "1851605471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 FOREST HARBOR DR",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370759645",
            "telephone_number": "615-264-1342",
            "fax_number": "615-431-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 FOREST HARBOR DR",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370759645",
            "telephone_number": "615-264-1342",
            "fax_number": "615-431-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLCHEK",
        "first_name": "MARY",
        "middle_name": "LOU",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-06",
        "last_updated": "2010-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "PTA0000001871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelair Piro
• Play Ball Children'S Therapy, LLC
• Clair S Poff, D.D.S.
• Erica Poima, RBT
• Ron Poland
• Jessica Pollock, PT
• Rachel Poole, PT. DPT
• Jessica M.L Porter
• Shervetta Renee Porter, MA
• Michael Alvin Post, PHARM.D.

• Physical Therapy Assistant in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.