BRADLEY POLK WALK IN CLINIC NPI 1770929333

NPI Information

  • NPI: 1770929333
  • Provider Name: BRADLEY POLK WALK IN CLINIC
  • Classification: Clinic/Center - 261QR1300X
  • Specialization: Rural Health
  • Entity Type: Organization
  • CLIA Number: 44D2060419
  • Address: 119 WHITE WATER DR
    OCOEE, TN
    ZIP 37361
  • Phone: (423) 299-9435

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NPI Details

BRADLEY POLK WALK IN CLINIC is a rural health clinic center in Ocoee, TN. BRADLEY POLK WALK IN CLINIC NPI is 1770929333. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

119 WHITE WATER DR
OCOEE, TN
ZIP 37361-645
Phone: (423) 299-9435

The provider's authorized official is Tami Solberg Brehen .
The authorized official title is Co-owner and has the following contact phone number (423) 299-9435.

The CLIA number assigned to this NPI record is 44D2060419 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/21/2013 and was last updated on 11/8/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineNo
2261QR1300XClinic/CenterRural HealthYes
3363LF0000XNurse PractitionerFamilyAPN15727TENNESSEENo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1Q002302MEDICAIDTENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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