BRADLEY POLK WALK IN CLINIC (NPI# 1770929333) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770929333 |
| Entity Type | Organization |
| Organization Name | BRADLEY POLK WALK IN CLINIC |
| Practice Address |
119 White Water Dr Ocoee TN 37361-3645 |
| Practice Telephone | 4232999435 |
| Mailing Telephone | 4232999435 |
| Mailing Fax Number | 4232999436 |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2019-11-08 |
| Authorized Official Name | TAMI SOLBERG BREHEN (CO-OWNER) |
| Authorized Official Telephone | 4232999435 |
| Authorized Official Credential | NP-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN15727 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | Q002302 | 05 |
| Street Address |
119 WHITE WATER DR |
| City | OCOEE |
| State | TN |
| Zip Code | 37361-3645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316546492 | Amanda Brooke Davis | Nurse Practitioner | 119 White Water Dr, Ocoee, TN 37361-3645 | 2020-10-20 |
| 1780234484 | Stephanie Julienne Hamel | Nurse Practitioner | 119 White Water Dr, Ocoee, TN 37361-3645 | 2019-09-14 |
| 1720568462 | Kaitlin Weeks | Physician Assistant | 119 White Water Dr, Ocoee, TN 37361-3645 | 2018-08-21 |
| 1225575756 | Kimberly Delaney | Nurse Practitioner | 119 White Water Dr, Ocoee, TN 37361-3645 | 2017-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740673235 | Ocoee Pharmacy, Inc | Pharmacy | 186 Creekside Dr, Ocoee, TN 37361 | 2015-03-09 |
| 1376947085 | Dora D. Trivette | Nurse Practitioner | 2020 Keith Street Nw, Suite C, Cleveland, TN 37361 | 2014-10-09 |
| 1326487752 | Bethany Randolph Hogan | Nurse Practitioner | 119 Whitewater Drive, Bradley Polk Walk In Clinic and Medical Center, Ocoee, TN 37361 | 2013-06-19 |
| 1326055591 | Preferred Oxygen LLC | Durable Medical Equipment & Medical Supplies | 134 Creekside Dr., Suite #2, Ocoee, TN 37361 | 2006-08-01 |
| 1952754707 | Samuel Randolph | Pharmacist | 186 Creekside Dr, Ocoee, TN 37361 | 2016-07-18 |
| 1174921001 | Tennessee Valley Bone and Joint, PC | Orthopaedic Surgery | 119 Whitewater Drive, Ocoee, TN 37361 | 2014-12-09 |
| 1568645091 | David D Darden | Preventive Medicine | 1680 Sand Mountain Road, Ocoee, TN 37361-0335 | 2007-12-06 |
| 1912283458 | Karen Milen | Nurse Practitioner | 400 Blackberry Ln, Ocoee, TN 37361-3456 | 2011-10-28 |
| 1114310224 | Cooke Food Store Inc | Pharmacy | 116 White Water Dr, Ocoee, TN 37361-3644 | 2015-03-13 |
| 1760875686 | Thad Huff | Pharmacist | 116 White Water Dr, Ocoee, TN 37361-3644 | 2015-03-17 |
| Find all providers in zip 37361 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588275317 | Henry County Medical Center | Clinic/Center | 300 Hospital Cir Ste 204, Paris, TN 38242-4597 | 2020-08-14 |
| 1447861562 | Henry County Medical Center | Clinic/Center | 14201 Highway 79 N Unit 4, Buchanan, TN 38222-4183 | 2020-08-12 |
| 1003425224 | Dickson Medical Associate, PC | Clinic/Center | 127 Crestview Park Dr Ste 205, Dickson, TN 37055-2856 | 2020-07-23 |
| 1023631454 | Spring City Family Clinic Pllc | Clinic/Center | 126 Lavender St Ste 2, Spring City, TN 37381-5102 | 2020-05-20 |
| 1871001271 | Shelbyville Hospital Company LLC | Clinic/Center | 1330 Cedar Ln Ste 100, Tullahoma, TN 37388-2284 | 2018-01-19 |
| 1720596125 | Shelbyville Hospital Company LLC | Clinic/Center | 1440 Cedar Ln Unit 100, Tullahoma, TN 37388-2262 | 2018-01-19 |
| 1548788458 | Shelbyville Hospital Company LLC | Clinic/Center | 1612 N Main St Ste A, Shelbyville, TN 37160-2392 | 2017-08-31 |
| 1063938520 | Mid-south Convenient Care, Pllc | Clinic/Center | 1445 Us Highway 51 Byp E Ste B, Dyersburg, TN 38024-2127 | 2017-08-16 |
| 1871034462 | Martin Health | Clinic/Center | 143 Kennedy Drive, Martin, TN 38237-3309 | 2017-03-15 |
| 1881135895 | Humboldt Family Walk-in Clinic LLC | Clinic/Center | 1600 Coleman Dr, Humboldt, TN 38343-1756 | 2017-03-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.