Walter William Jolly, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

01020461A Issued in IN

Practice address

10101 Ditch Rd
Carmel, IN 46032-8897

Phone

(317) 574-0884

Fax

(317) 574-0886

NPI assigned

Nov 18, 2010

Last updated

Nov 18, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1013219435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 DITCH RD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328897",
            "telephone_number": "317-574-0884",
            "fax_number": "317-574-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 DITCH RD",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460328897",
            "telephone_number": "317-574-0884",
            "fax_number": "317-574-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "WALTER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-18",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "IN",
            "license": "01020461A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurene Martin Johnson
• Patricia K Johnson, MS
• Zoey Linn Johnson, PA-C
• William Marshall Johnston, MA, LMHC, LCAC
• Mary A Jolly, ANP-BC
• Allison Jonas
• Danielle Jones
• Jacqueline Rose Jones
• Jessica Erin Jones, LMHC
• Keith Jones

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Carmel, IN
• Providers in Carmel, IN by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.