Nichole Kristine Joly, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA031121 Issued in DC

Practice address

3800 Reservoir Rd NW
4PHC
Washington, DC 20007-2113

Phone

(202) 444-5022

NPI assigned

Jan 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nichole Kristine Greulich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1154474369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "address_2": "4PHC",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-444-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "address_2": "4PHC",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-444-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLY",
        "first_name": "NICHOLE",
        "middle_name": "KRISTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NY",
            "license": "010809",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "DC",
            "license": "PA031121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "GREULICH",
            "middle_name": "KRISTINE",
            "credential": "RPA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sandra Nicole Jolles, MS, CNS
• Nicole Shantel Jolley, CPM
• Connie Sylean Jolly
• Eglin Gloriana Jolly
• Jhanai Joly, DC
• Jon M Wiseman MD PC
• Jona Adult & Children Psychiatry Inc
• Guyford Jonas, PA
• Richard A Jonas, M.D.
• George Titus Joncas, DDS

• Surgical Physician Assistant in Washington, DC
• Providers in Washington, DC by specialty
• Surgical Physician Assistant in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.