Jack Nathan Poles, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

AP6412085 Issued in AZ

Practice address

9100 N 2ND St
Suite 121
Phoenix, AZ 85020-2446

Phone

(602) 997-7331

Fax

(602) 870-4512

NPI assigned

Nov 16, 2005

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

Medicare fee-for-service enrollment

Enrolled in AZ

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 Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jack.poles.1@5919.direct.athenahealth.com

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

• Honorhealth Medical Group, LLC

  • Primary Care Clinic/Center
  • Peoria, AZ
  • NPI 1043851793
  Medicare reassignment NPD
• Honorhealth Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1740273614
  Medicare reassignment NPD
• Honorhealth Medical Group, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1033104716
  NPD
• Honorhealth Medical Group, LLC

  • Family Medicine Physician
  • Scottsdale, AZ
  • NPI 1285338343
  NPD
• Honorhealth Medical Group, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1689136160
  NPD
• Honorhealth Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Scottsdale, AZ
  • NPI 1700423415
  NPD
• Squaw Peak Family Physicians PC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1578590303
  NPD

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1962484949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 W UTOPIA RD",
            "address_2": "STE. 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274171",
            "telephone_number": "602-214-6148",
            "fax_number": "602-214-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 N 2ND ST",
            "address_2": "SUITE 121",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850202446",
            "telephone_number": "602-997-7331",
            "fax_number": "602-870-4512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLES",
        "first_name": "JACK",
        "middle_name": "NATHAN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "AP6412085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD CERT #",
            "identifier": "41884",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Ervin Polakowski
• Joan Marie Polansky, PH.D.
• Polaris Medical Group LLC
• Delia Mae Poleahla, RN.
• Elizabeth Polen, LPC
• Sharon L Polintan, P.T.
• Polite Canoe Therapy and Wellness, PLLC
• Eugenia G. Politis, M.D.
• Samantha A Polito, AG-ACNP
• Mordechai Polityko, LMFT

• Internal Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.