Individual provider Active NPI

Pollyanna Lam, D.O.

  • Pediatrics Physician
  • Huntington, WV
National Provider Identifier
1972545101
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
4283 Issued in WV
Practice address
3075 US Route 60
Door D
Huntington, WV 25705-8859
Phone
(304) 399-4422
Fax
(304) 399-4433
NPI assigned
Jun 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4283 WV Primary

Addresses

Primary practice location

3075 US Route 60
Door D
Huntington, WV 25705-8859

Mailing address

1448 10TH Avenue
Suite 304
Huntington, WV 25701-3579
Phone (304) 691-6381

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pollyanna.lam@marshall.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20241017001029 WV Practitioner - Pediatric Medicine 3375646383 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
4283WVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians & Surgeons, Inc Pediatrics CurrentSince Oct 21, 2024 Accepting new patients
University Physicians & Surgeons, Inc. CurrentSince Oct 21, 2024 Accepting new patients

Locations

3075 US Route 60
#D
Huntington, WV 25705
Phone (304) 399-4422

1600 Medical Center Dr
Ste 3500
Huntington, WV 25701
Phone (304) 691-1300

1448 10th Ave
Ste 304
Huntington, WV 25701
Phone (304) 691-6381

Interoperability endpoints

  • Direct secure messaging: plam303301@direct.ochin.org
  • Direct secure messaging: pollyanna.lam@marshall.cernerdirect.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1972545101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 10TH AVENUE",
            "address_2": "SUITE 304",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257013579",
            "telephone_number": "304-691-6381",
            "fax_number": "304-691-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 US ROUTE 60",
            "address_2": "DOOR D",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257058859",
            "telephone_number": "304-399-4422",
            "fax_number": "304-399-4433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "POLLYANNA",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "4283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pollyanna.lam@marshall.cernerdirect.com",
            "affiliation": "N",
            "address_1": "3075 US Route 60",
            "address_2": "Door D",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "257058859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

Verify at the official NPI Registry.