Juan Polanco, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110008672 Issued in VA

Practice address

6051 Belspring Rd
Fairlawn, VA 24141-8567

Phone

(540) 509-5443

Fax

(855) 889-9037

NPI assigned

May 21, 2014

Last updated

May 11, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Premier Community Healthcare Group Inc

  • Federally Qualified Health Center (FQHC)
  • Dade City, FL
  • NPI 1841263399
  Medicare reassignment NPD
• New River Valley Medicine, P.C.

  • Internal Medicine Physician
  • Fairlawn, VA
  • NPI 1235641465
  NPD
• New River Valley Urgent Care LLC

  dba New River Valley Urgent Care

  • Internal Medicine Physician
  • Fairlawn, VA
  • NPI 1760286611
  NPD
• Premier Community Healthcare Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Zephyrhills, FL
  • NPI 1508445362
  NPD

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778457600000",
    "number": "1992117311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6051 BELSPRING RD",
            "city": "FAIRLAWN",
            "state": "VA",
            "postal_code": "241418567",
            "telephone_number": "540-509-5443",
            "fax_number": "855-889-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 BELSPRING RD",
            "city": "FAIRLAWN",
            "state": "VA",
            "postal_code": "241418567",
            "telephone_number": "540-509-5443",
            "fax_number": "855-889-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "JUAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-21",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110008672",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701005818",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New River Economy Drug Inc
• New River Valley Medicine, P.C.
• New River Valley Urgent Care LLC (New River Valley Urgent Care)
• NRV Oral & Maxillofacial Surgery, LTD (NRV Oral & Maxillofacial Surgery - Radford)
• Whitney Chase Petrie, LCSW
• Polaski County Board of Supervisors
• Benjamin Carroll Poovey
• Lisa Pugh, LPC
• Gershon Silber, M.D.
• Stephanie Whited, LCSW LLC

• Medical Physician Assistant in Fairlawn, VA
• Providers in Fairlawn, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.