Active NPI
Mary Anne Polucha, DC
- Chiropractor
- Truckee, CA
National Provider Identifier
1871654616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 20859
- Practice address
- 13450 Donner Pass Rd
A
Truckee, CA 96161-0456 - Phone
- (530) 582-1228
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 20859 | CA | Primary |
Addresses
Primary practice location
13450 Donner Pass Rd
A
Truckee, CA 96161-0456
Mailing address
13450 Donner Pass Rd Apt a
Truckee, CA 96161-3889
Phone (775) 225-0380
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20859 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645920000000",
"number": "1871654616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13450 DONNER PASS RD APT A",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961613889",
"telephone_number": "775-225-0380",
"fax_number": "530-323-3832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13450 DONNER PASS RD",
"address_2": "A",
"city": "TRUCKEE",
"state": "CA",
"postal_code": "961610456",
"telephone_number": "530-582-1228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLUCHA",
"first_name": "MARY ANNE",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2022-02-27",
"certification_date": "2022-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "20859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Truckee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.