MR. NATHAN W POLLEY MD
Complete NPI Record 1003105529
Orthopaedic Surgery in Madison, IN
Active since April 05, 2011PECOS EnrolledAccepts Medicare Assignment
77.27/100
CMS Quality Rating
Complete NPI Dataset
This page contains the complete raw NPPES record for Mr. Nathan W Polley, MD (NPI 1003105529), an individual orthopaedic surgery provider in Madison, IN. All 46 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1003105529 Field 1/46
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/46
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: POLLEY Field 3/46
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: NATHAN Field 4/46
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: W Field 5/46
- The middle name of the provider, if the provider is an individual.
- Provider Name Prefix Text: MR. Field 6/46
- The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
- Provider Credential Text: MD Field 7/46
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: PO BOX 776351 Field 8/46
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: CHICAGO Field 9/46
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: IL Field 10/46
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 606776351 Field 11/46
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 12/46
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 5025889490 Field 13/46
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 5022725116 Field 14/46
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 1373 E STATE ROAD 62 STE 2A Field 15/46
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: MADISON Field 16/46
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: IN Field 17/46
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 472507328 Field 18/46
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 19/46
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 8128010848 Field 20/46
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 8128010773 Field 21/46
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 24/46
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 207X00000X Field 25/46
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: TP300 Field 26/46
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: KY Field 27/46
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 28/46
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 390200000X Field 29/46
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 30/46
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 3: 207X00000X Field 31/46
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 3: 49607 Field 32/46
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 3: KY Field 33/46
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 3: N Field 34/46
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 4: 207X00000X Field 35/46
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 4: 01081100A Field 36/46
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 4: IN Field 37/46
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 4: Y Field 38/46
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 201393180 Field 39/46
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 40/46
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: IN Field 41/46
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier 2: 7100211870 Field 42/46
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 2: 05 Field 43/46
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 2: KY Field 44/46
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Sole Proprietor: N Field 45/46
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 20
Additional practice locations on file with NPPES beyond the primary practice address.
9880 Angies Way Ste 205
Location 1/20Louisville, KY 40241-2858 · Phone (502) 394-6341 · Fax (502) 394-6340
1230 Market St
Location 2/20LA Grange, KY 40031-7986 · Phone (502) 394-6341 · Fax (502) 394-6340
150 Frankfort Rd Ste 102B
Location 3/20Shelbyville, KY 40065-7401 · Phone (502) 633-9030 · Fax (502) 633-9093
8033 Dixie Hwy
Location 4/20Louisville, KY 40258-1344 · Phone (502) 449-6448 · Fax (502) 449-6455
3 Audubon Plaza Dr Ste 620
Location 5/20Louisville, KY 40217-1362 · Phone (502) 449-6448 · Fax (502) 449-6455
1220 Spring St
Location 6/20Jeffersonville, IN 47130-3704 · Phone (812) 282-8494 · Fax (812) 288-4481
9451 Westport Rd Ste 122C
Location 7/20Louisville, KY 40241-2295 · Phone (502) 855-7325 · Fax (502) 855-7326
309 11th St
Location 8/20Carrollton, KY 41008-1435 · Phone (502) 732-3204 · Fax (502) 732-3212
130 Hunter Station Way Ste 230
Location 9/20Sellersburg, IN 47172-8930 · Phone (812) 282-8494 · Fax (812) 288-4481
9880 Angies Way Ste 250
Location 10/20Louisville, KY 40241-2865 · Phone (502) 394-6341 · Fax (502) 394-6340
3707 Charlestown Rd Ste C1
Location 11/20New Albany, IN 47150-9254 · Phone (812) 944-4720 · Fax (812) 590-2296
2412 Ring Rd Ste 100
Location 12/20Elizabethtown, KY 42701-5912 · Phone (502) 855-7325 · Fax (502) 855-7326
3 Audubon Plaza Dr Ste 430
Location 13/20Louisville, KY 40217-1319 · Phone (502) 636-4900 · Fax (502) 636-4901
9300 Stonestreet Rd Ste 200
Location 14/20Louisville, KY 40272-2894 · Phone (502) 449-6448 · Fax (502) 449-6455
210 E Gray St Ste 604
Location 15/20Louisville, KY 40202-3902 · Phone (502) 629-5633 · Fax (502) 629-5580
4123 Dutchmans Ln Ste 100
Location 16/20Louisville, KY 40207-4707 · Phone (502) 636-4905 · Fax (502) 636-4901
170 Dr Arla Way Ste 101
Location 17/20Louisville, KY 40229-5427 · Phone (502) 636-9226 · Fax (502) 636-0064
1461 N Gardner St
Location 18/20Scottsburg, IN 47170-7751 · Phone (812) 282-8494 · Fax (812) 288-4481
4123 Dutchmans Ln Ste 401
Location 19/20Louisville, KY 40207-4733 · Phone (502) 559-1400 · Fax (502) 559-1415
4123 Dutchmans Ln Ste 101
Location 20/20Louisville, KY 40207-4718 · Phone (502) 587-1236 · Fax (502) 587-0126
Other Provider Identifiers 2
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
201393180 Medicaid
Identifier 1/2State: IN
7100211870 Medicaid
Identifier 2/2State: KY
No registry entries match your active lookup criteria.
