Individual provider Active NPI

Christopher D Jolley, MD

  • Pediatric Gastroenterology Physician
  • Gainesville, FL
National Provider Identifier
1174563365
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
ME76208 Issued in FL
Practice address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone
(352) 733-0094
Fax
(352) 273-0392
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X ME76208 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd
Gainesville, FL 32610-3003

Mailing address

PO Box 918025
Orlando, FL 32891-8025
Phone (352) 733-0094

Other names 1

  • Christopher Douglas Jolley Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100928001642 FL Practitioner - Pediatric Medicine 8820114713 Reassigns benefits to 1 organization
I20250109000054 TX Practitioner - Pediatric Medicine 8820114713 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Texas Medical Branch at Galveston, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1935 Medical District Dr
Dallas, TX 75235-7701
Phone (844) 424-4537

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME76208FLMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 8, 2024 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 8, 2024 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 5

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204675200000",
    "number": "1174563365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025",
            "telephone_number": "352-733-0094",
            "fax_number": "352-273-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-733-0094",
            "fax_number": "352-273-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "CHRISTOPHER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2008-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "FL",
            "license": "ME76208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTOPHER",
            "last_name": "JOLLEY",
            "middle_name": "DOUGLAS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.