NPIMap

Individual provider Active NPI

Samantha Irene Jolly, MD

  • Emergency Medicine Physician
  • Searcy, AR
National Provider Identifier
1194220186
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-12915 Issued in AR
Practice address
3214 E Race Ave
Searcy, AR 72143-4810
Phone
(501) 268-6121
NPI assigned
Mar 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-12915 AR Primary

Addresses

Primary practice location

3214 E Race Ave
Searcy, AR 72143-4810

Mailing address

3214 E Race Ave
Searcy, AR 72143-4810
Phone (501) 380-3172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200615002826 AR Practitioner - Emergency MedicinePractitioner - Family Practice 0648692970 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Unity Health - JacksonvilleGroup PAC ID 8325418882, 18 clinicians
White County Medical CenterGroup PAC ID 4880688654, 182 clinicians

Practice addresses (Care Compare)

1400 Braden St
Jacksonville, AR 72076-3721
Phone (501) 380-3172

3214 E Race Ave
Searcy, AR 72143-4810
Phone (501) 380-1010

Hospital & facility affiliations

  • White County Medical Center Hospital, Searcy, AR, CCN 040014
  • Unity Health - Jacksonville Hospital, Jacksonville, AR, CCN 040164

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Health - Newport Current Accepting new patients
Unity Health - Jacksonville CurrentSince Mar 20, 2024 Accepting new patients
Unity Health - Jacksonville Emergency Medicine CurrentSince Mar 20, 2024 Accepting new patients
Unity Health - Newport CurrentSince Sep 30, 2022 Accepting new patients
Unity Health - Newport CurrentSince Sep 30, 2022 Accepting new patients
White County Medical Center Emergency Medicine CurrentSince Sep 23, 2021 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince May 1, 2021 Accepting new patients

Locations

1 Medical Park Dr
Bryant, AR 72015
Phone (501) 776-6000

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

1400 Braden St
Little Rock AFB, AR 72076
Phone (501) 380-3172

1117 McLain St
Ste 500
Newport, AR 72112
Phone (870) 523-6464

1205 McLain St
Newport, AR 72112
Phone (870) 512-3441

3214 E Race Ave
Searcy, AR 72143
Phone (501) 268-6121

2900 Hawkins Dr
Searcy, AR 72143
Phone (501) 278-2800

Organizations & group practices 7

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.

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1194220186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3214 E RACE AVE",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721434810",
            "telephone_number": "501-380-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 E RACE AVE",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721434810",
            "telephone_number": "501-268-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "SAMANTHA",
        "middle_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-29",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-12915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Searcy, AR

Sources for this page

Verify at the official NPI Registry.