Individual provider Active NPI

Dala R Jarolim, MD FACP

  • Internal Medicine Physician
  • Jenks, OK
National Provider Identifier
1114997582
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11015 Issued in OK
Practice address
1217 W Main St
Jenks, OK 74037-2311
Phone
(918) 747-6673
Fax
(918) 296-8010
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

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 11015 OK Primary

Addresses

Primary practice location

1217 W Main St
Jenks, OK 74037-2311

Mailing address

1217 W Main St
Jenks, OK 74037-2311
Phone (918) 747-6673

Other identifiers 1

IdentifierTypeStateIssuer
100094720DMedicaidOK

Other names 1

  • Dala R Jarolim Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11015OKMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Rehabilitation Services of Tulsa, Inc. PastSince Apr 30, 2003 Accepting new patients

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375056000000",
    "number": "1114997582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 W MAIN ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740372311",
            "telephone_number": "918-747-6673",
            "fax_number": "918-296-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 W MAIN ST",
            "city": "JENKS",
            "state": "OK",
            "postal_code": "740372311",
            "telephone_number": "918-747-6673",
            "fax_number": "918-296-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAROLIM",
        "first_name": "DALA",
        "middle_name": "R",
        "credential": "MD FACP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2013-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "11015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100094720D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DALA",
            "last_name": "JAROLIM",
            "middle_name": "R",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jenks, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.