Kristina Lucille Polley, PA-C
NPI 1700274313ActiveIndividual· Physician Assistant· Fayetteville, NC
Physician Assistant (PA-C) with Lifesource of North Carolina and 1 other group, practicing in Fayetteville, North Carolina. Enrolled in Medicare as practitioner - physician assistant.
Overview
| NPI | 1700274313 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Jan 5, 2015 |
| Last updated in NPPES | Mar 18, 2025 |
| Certified by provider | Mar 18, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 0010-05418 | NC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (NC) |
|---|
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Physician Assistant |
| Telehealth | Offers telehealth |
Medical groups
- Lifesource of North CarolinaClinton, SC · 178 clinicians
- Lifesource Prime IncClinton, SC · 53 clinicians
Other facilities
- Amedisys Home Health of FayettevilleHome health agency · Fayetteville, NC
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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