Individual provider Active NPI

Michael Bryant Jolley, M.D.

  • Internal Medicine Physician
  • American Fork, UT
National Provider Identifier
1114197159
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
7512897-1205 Issued in UT
Practice address
170 N 1100 E
American Fork, UT 84003-2096
Phone
(801) 357-8310
NPI assigned
Mar 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 7512897-1205 UT Primary

Addresses

Primary practice location

170 N 1100 E
American Fork, UT 84003-2096

Mailing address

170 N 1100 E
American Fork, UT 84003-2096
Phone (801) 357-8310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100420000449 UT Practitioner - Internal Medicine 5294862470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

170 N 1100
American Fork, UT 84003-2096
Phone (801) 357-8310

Hospital & facility affiliations

  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
  • Intermountain Health Spanish Fork Hospital Hospital, Spanish Fork, UT, CCN 460062
  • American Fork Hospital Hospital, American Fork, UT, CCN 460023
  • Intermountain Health Delta Community Hospital Hospital, Delta, UT, CCN 461300
  • Gunnison Valley Hospital Hospital, Gunnison, UT, CCN 461306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
7512897-1205UTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Mar 14, 2010 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Mar 14, 2010 Accepting new patients

Locations

170 N 1100 E
American Fork, UT 84003
Phone (801) 714-6570

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

Organizations & group practices 3

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1114197159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 N 1100 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032096",
            "telephone_number": "801-357-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 N 1100 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032096",
            "telephone_number": "801-357-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "MICHAEL",
        "middle_name": "BRYANT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-05",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "7512897-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.