Individual provider Active NPI

Nina Jolley, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1023684669
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA14615 Issued in TX
Practice address
12200 Renfert Way Ste 100
Austin, TX 78758-5654
Phone
(512) 451-8211
NPI assigned
Jun 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA14615 TX Primary

Addresses

Primary practice location

12200 Renfert Way Ste 100
Austin, TX 78758-5654

Mailing address

12200 Renfert Way Ste 100
Austin, TX 78758-5654

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326002700 TX Practitioner - Physician Assistant 0446697411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aa OBGYN PLLCGroup PAC ID 6103079462, 38 clinicians

Practice addresses (Care Compare)

12200 Renfert Way
Suite 100
Austin, TX 78758-5614
Phone (512) 451-8211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1622678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1023684669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 RENFERT WAY STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 RENFERT WAY STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787585654",
            "telephone_number": "512-451-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "NINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-03",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA14615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.