Donald Gabriel Polk, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO1538 Issued in TN

Practice address

103 JV Mangubat Dr
Waynesboro, TN 38485-2440

Phone

(931) 762-9418

Fax

(931) 722-9081

NPI assigned

Sep 7, 2005

Last updated

Jan 10, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

• Dr. D. Gabriel Polk Other name

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southeastern Emergency Physicians LLC

  • Emergency Medicine Physician
  • Maysville, KY
  • NPI 1356379382

  TN

  Medicare reassignment NPD
• Perry County Community Hospital Inc

  • Critical Access Hospital
  • Linden, TN
  • NPI 1528890480
  Medicare reassignment
• Waynesboro Clinic, LLC

  • Family Medicine Physician
  • Waynesboro, TN
  • NPI 1407207814
  NPD
• Maury Regional Hospital

  dba Wayne Medical Center

  • General Acute Care Hospital
  • Waynesboro, TN
  • NPI 1811927544
  NPD (past)
• National Health Corporation

  • Skilled Nursing Facility
  • Lawrenceburg, TN
  • NPI 1306883749
  NPD (past)
• NHC Healthcare-Pulaski, LLC

  • Skilled Nursing Facility
  • Pulaski, TN
  • NPI 1275570137
  NPD (past)
• NHC Healthcare-Scott LLC

  • Skilled Nursing Facility
  • Lawrenceburg, TN
  • NPI 1720033681
  NPD (past)
• Renuven Health Partners of Georgia PC

  • Internal Medicine Physician
  • Fort Oglethorpe, GA
  • NPI 1871196519
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1942294863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2717 EAST OAKLAND AVENUE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011843",
            "telephone_number": "423-926-2358",
            "fax_number": "423-926-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 JV MANGUBAT DR",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852440",
            "telephone_number": "931-762-9418",
            "fax_number": "931-722-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "DONALD",
        "middle_name": "GABRIEL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2024-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "DO1538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33079841",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "D.",
            "last_name": "POLK",
            "middle_name": "GABRIEL",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rhonda Penelope Moore, LPTA
• Khearra Mosley, MA
• MRH Dba WMC
• Joseph C. Murphy, D.PH.
• Ashley Danielle Musselwhite
• Donald H Polk, DO
• Alexandria Nicole Popeholt, MSN, FNP
• Kendra R Prater-Holt, NP
• Donna J Prater, APN
• Nelda Prater, M.A.

• Family Medicine Physician in Waynesboro, TN
• Providers in Waynesboro, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.