Individual provider Active NPI

B Jeffrey Jolley, D.C.

  • Neurology Chiropractor
  • Mesa, AZ
National Provider Identifier
1255470753
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
AZ3768 Issued in AZ
Practice address
2220 S Country Club Dr
Suite 102
Mesa, AZ 85210-6887
Phone
(480) 633-8293
Fax
(480) 926-1564
NPI assigned
Feb 5, 2007
Last updated
Feb 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X AZ3768 AZ Primary
Neurology Chiropractor 111NN0400X 3768 AZ

Addresses

Primary practice location

2220 S Country Club Dr
Suite 102
Mesa, AZ 85210-6887

Mailing address

2220 S Country Club Dr
Suite 102
Mesa, AZ 85210-6887
Phone (480) 633-8293

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120116000050 AZ Practitioner - Chiropractic 0446235741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2220 S Country Club Dr
Suite 102
Mesa, AZ 85210-6808
Phone (480) 633-8293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AZ3768AZMDNeurology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Total Back Care, PLC CurrentSince Apr 30, 2003 Accepting new patients

Locations

2220 S Country Club Dr
Ste 102
Mesa, AZ 85210
Phone (480) 633-8293

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487808000000",
    "number": "1255470753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 S COUNTRY CLUB DR",
            "address_2": "SUITE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106887",
            "telephone_number": "480-633-8293",
            "fax_number": "480-926-1564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 S COUNTRY CLUB DR",
            "address_2": "SUITE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106887",
            "telephone_number": "480-633-8293",
            "fax_number": "480-926-1564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "B",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2017-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "AZ",
            "license": "AZ3768",
            "primary": true
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "AZ",
            "license": "3768",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.