Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KYLE BRANDON POLLEY STUDENT
NPI 1396302535
Family Medicine - Sports Medicine in La Grange, KY

Active since May 23, 2019PECOS Enrolled
1023 NEW MOODY LN STE 102, LA GRANGE, KY 40031(502) 222-0598(502) 222-7446 Get Directions Write a Review

NPPES record last updated: August 18, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 18, 2026, May 23, 2019 (2 updates tracked since 2019).

About Kyle Brandon Polley Student NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KYLE BRANDON POLLEY STUDENT (NPI 1396302535) is an individual sports medicine provider in La Grange, Kentucky, licensed in Kentucky (61083) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS and maintains a secondary practice location in Louisville.

NPPES Registry Identity

NPI1396302535
Entity TypeIndividualMale
Primary Taxonomy207QS0010X
Provider Legal NameKYLE BRANDON POLLEYCredential: STUDENT
Location Address1023 NEW MOODY LN STE 102La Grange, KY 40031-9183
Mailing Address1901 Campus PlLouisville, KY 40299-2308 · (502) 222-0598
Fax(502) 222-7446
Sole ProprietorNo
Enumeration DateMay 23, 2019
Last NPPES UpdateAugust 18, 20262 updates tracked since enumeration
NPPES CertifiedAugust 18, 2026
NPI 1396302535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License Licensed in KY · 61083
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
1023 NEW MOODY LN STE 102, La Grange, KY 40031

Secondary Practice Location 1

Location 1500 S Preston St Rm 305Louisville, KY 40202-1702 · Phone (502) 852-8696

Other Identifiers 1

Other390200000XUlsom

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Kyle Brandon Polley Student is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40031 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Specialist/Technologist, Other (Surgical Assistant)
1023 NEW MOODY LN STE 102
LA GRANGE, KY 40031
Physician Assistant (Medical)
1023 NEW MOODY LN STE 102
LA GRANGE, KY 40031

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kyle Polley's NPI number?

The NPI number for Kyle Polley is 1396302535. It was assigned to this individual provider in the NPPES registry on May 23, 2019.

Where is Kyle Polley located?

Kyle Polley practices at 1023 New Moody Ln Ste 102, La Grange, KY 40031. The listed phone number is (502) 222-0598.

What is Kyle Polley's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Kyle Polley enrolled in Medicare?

Yes. Kyle Polley is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kyle Polley was last updated on August 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.