Marlin Lee Jolly

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

C003250 Issued in AR

Practice address

9040 Jackson Ave
Tacoma, WA 98431-0001

Phone

(253) 968-1110

NPI assigned

Jul 24, 2018

Sex

Male

Sole proprietor

No

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

Enrolled in AR

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renew Medical Group of Arkansas LTDGroup PAC ID 3173056298, 129 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Northwest Arkansas Hospital, Rogers, AR, CCN 040010
• Mercy Hospital Fort Smith Hospital, Fort Smith, AR, CCN 040062

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• Renew Medical Group of Arkansas LTD

  • Anesthesiology Physician
  • Fort Smith, AR
  • NPI 1215755947

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Premier Anesthesia of Arkansas Professional Corporation

  • Anesthesiology Physician
  • Fayetteville, AR
  • NPI 1932519485

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Capital Anesthesia Solutions of Arkansas, LLC

  • Anesthesiology Physician
  • Fayetteville, AR
  • NPI 1174125876

  Nurse Anesthetist, Certified Registered

  NPD
• Northeast Arkansas Clinic Charitable Foundation, Inc.

  • Anesthesiology Physician
  • Jonesboro, AR
  • NPI 1992036032
  NPD (past)

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

• Mercy Hospital Fort Smith

  • General Acute Care Hospital
  • Fort Smith, AR
  • NPI 1568433480
  Care Compare affiliation
• Mercy Hospital Rogers

  • General Acute Care Hospital
  • Rogers, AR
  • NPI 1316902414
  Care Compare affiliation

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1174000913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "MARLIN",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "C003250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Nicole Johnston, RBT-19-91755
• Scottia Elise Johnston, LMP
• Vanee Joiner
• Patricia Danielle Jolley, LMT
• Linda L Jollo, LMP
• Jon F Geffen DO PC
• Jon M Pettibon DC Inc PS
• Hillary S Jonas, LICSW
• Jonathan L Ritson MD PS
• Cassandra Jones Morgan

• Certified Registered Nurse Anesthetist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.