Victor Poletajev, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC-001053 Issued in TN

Practice address

5107 Bryson TRL
Murfreesboro, TN 37129-3063

Phone

(615) 867-7522

Fax

(615) 867-3288

NPI assigned

Nov 8, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1912988841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 BRYSON TRL",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293063",
            "telephone_number": "615-867-7522",
            "fax_number": "615-867-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5107 BRYSON TRL",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371293063",
            "telephone_number": "615-867-7522",
            "fax_number": "615-867-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLETAJEV",
        "first_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WV",
            "license": "528",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC-003771-L",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1878",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC-001053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3093995",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4482273",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Poe, LMT
• Erica Pogel
• Shannon Lea Pogue, PT
• Timothy F Pogue, CRNA
• Rachel L Poldervaart
• James K Poliner, MD
• Jenna Polk, PHARMD
• Kendla Polk, PT
• Rasheta Polk
• Chelsea Nicole Pollard, PA-C

• Chiropractor in Murfreesboro, TN
• Providers in Murfreesboro, TN by specialty
• Chiropractor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.