Maxwell David Jolly, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

32963 Issued in OK

Practice address

101 Manning Dr
Chapel Hill, NC 27514-4220

Phone

(984) 974-1000

NPI assigned

Apr 13, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Anesthesiology

Education

University of Kansas School of Med (KC/Wich/Sal), 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kansas Spine Anesthesia Corporation PAGroup PAC ID 1153586821, 56 clinicians

Wichita Anesthesiology CharteredGroup PAC ID 4587577796, 68 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wesley Medical Center Hospital, Wichita, KS, CCN 170123

Merit-based Incentive Payment System (MIPS)

Final score

40.05 of 100Reported as group

Quality

47.12

Improvement activities

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjolly702655@direct.unc.nchie.net

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.

• Kansas Spine Anesthesia Corporation PA

  • Pain Medicine (Anesthesiology) Physician
  • Wichita, KS
  • NPI 1720345911
  Medicare reassignment Care Compare group NPD
• Wichita Anesthesiology Chartered

  • Anesthesiology Physician
  • Wichita, KS
  • NPI 1407848450
  Medicare reassignment Care Compare group

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

• Wesley Medical Center LLC

  • Land Ambulance
  • Wichita, KS
  • NPI 1205760006

  Hospital

  Care Compare affiliation
• Wesley Medical Center LLC

  • General Acute Care Hospital
  • Wichita, KS
  • NPI 1447299649
  Care Compare affiliation

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1184158438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 NW 54TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731122150",
            "telephone_number": "319-390-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "984-974-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4409 NW 54th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731122150",
            "country_code": "US",
            "telephone_number": "316-390-8655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "MAXWELL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2021-08-31",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "32963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mjolly702655@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "101 Manning Dr",
            "city": "Chapel Hill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275144220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lisa B Johnston
• Margaret Balfe Johnston, LCSW
• Thomas Pace Johnston, M.D.
• Vann S. Joines, PH.D.
• Michael Jokich, LCSW
• Puneet Singh Jolly, MD/PHD
• Beth L Jonas, MD
• Maura Elise Jones Pullins, MD
• Alannah Lurene Jones
• Alexis Jones, PHARMD

• Anesthesiology Physician in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Anesthesiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.