Ronnie Polk

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2931-123 Issued in WI

Practice address

3353 N Martin Luther King Dr
Milwaukee, WI 53212-1455

Phone

(414) 559-6121

Fax

(141) 445-7858

NPI assigned

Jun 6, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mr. Ronnie Polk Professional name

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": "1244246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244246400000",
    "number": "1912133794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4754 N 40TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532095812",
            "telephone_number": "414-466-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3353 N MARTIN LUTHER KING DR",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532121455",
            "telephone_number": "414-559-6121",
            "fax_number": "141-445-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "RONNIE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-06",
        "last_updated": "2009-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2931-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL PROVIDER ID NUMBER",
            "identifier": "1437325032",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RONNIE",
            "last_name": "POLK",
            "prefix": "MR.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Courtney Pokrzywa, MD
• Debra J. Poliak, CRNA
• Poligons Home Health Care LLC
• David Polinger-Hyman, MD
• Libbie D Polk, LPN
• Krista Starr Pollack, M.S.
• Steven Erich Kenneth Pollack, CAA
• Holly Marie Pollard-Wright, DVM
• Rachel Anne Pollard, NP
• Joseph Pollei

• Clinical Social Worker in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Social Worker in Wisconsin

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

Verify at the official NPI Registry.