Active NPI
Kaitlyn Mackenzi Pollard
- Technician/Technologist
- Ardmore, OK
National Provider Identifier
1992201487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician/Technologist
- License
- K083636788
- Practice address
- 326 Boggy Creek Dr
Ardmore, OK 73401-6698 - Phone
- (580) 798-4523
- Fax
- (580) 319-5349
- NPI assigned
- Apr 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician/Technologist | 156F00000X | K083636788 | OK | Primary |
Addresses
Primary practice location
326 Boggy Creek Dr
Ardmore, OK 73401-6698
Mailing address
326 Boggy Creek Dr
Ardmore, OK 73401-6698
Phone (580) 798-4523
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K083636788 | Other | OK | DRIVERS LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K083636788 | OK | MD | Technician/Technologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1522713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522713600000",
"number": "1992201487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 BOGGY CREEK DR",
"city": "ARDMORE",
"state": "OK",
"postal_code": "734016698",
"telephone_number": "580-798-4523",
"fax_number": "580-319-5349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "326 BOGGY CREEK DR",
"city": "ARDMORE",
"state": "OK",
"postal_code": "734016698",
"telephone_number": "580-798-4523",
"fax_number": "580-319-5349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLLARD",
"first_name": "KAITLYN",
"middle_name": "MACKENZI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-03",
"last_updated": "2018-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "156F00000X",
"taxonomy_group": "",
"desc": "Technician/Technologist",
"state": "OK",
"license": "K083636788",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVERS LICENSE",
"identifier": "K083636788",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ardmore, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.