Individual provider Active NPI

Carla M Jolley, MN, ARNP, ACHPN

  • Adult Health Nurse Practitioner
  • Coupeville, WA
National Provider Identifier
1407063993
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP30004914 Issued in WA
Practice address
101 N Main St
Coupeville, WA 98239-3413
Phone
(360) 914-5634
Fax
(360) 678-7621
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X AP30004914 WA Primary

Addresses

Primary practice location

101 N Main St
Coupeville, WA 98239-3413

Mailing address

1799 Watkins Rd
Freeland, WA 98249-9597
Phone (360) 320-2250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140121002039 WA Practitioner - Nurse Practitioner 6709014715 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Washington School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whidbey Island Public Hospital DistrictGroup PAC ID 1658280680, 100 clinicians

Practice addresses (Care Compare)

275 SE Cabot Dr
B101 Whidbeyhealth Primary Care
Oak Harbor, WA 98277-3740
Phone (360) 675-6648

Hospital & facility affiliations

  • Whidbeyhealth Medical Center Hospital, Coupeville, WA, CCN 501339

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30004914WAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Whidbey Island Public Hospital District CurrentSince Dec 9, 2013 Accepting new patients
Whidbey Island Public Hospital District Current Accepting new patients
WGH Primary Care Associates, P.S. Current Accepting new patients
Whidbey Island Public Hospital District CurrentSince Dec 9, 2013 Accepting new patients
Whidbey Island Public Hospital District Past Accepting new patients

Locations

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

101 N Main St
Coupeville, WA 98239
Phone (360) 678-7656

275 SE Cabot Dr
Ste B101
Oak Harbor, WA 98277
Phone (360) 675-6648

Interoperability endpoints

  • Direct secure messaging: carla.jolley@wh.jhie.net
  • Direct secure messaging: jollec@direct.whidbeygen.org
  • Direct secure messaging: carla.joller@wh.jhie.net

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1407063993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1799 WATKINS RD",
            "city": "FREELAND",
            "state": "WA",
            "postal_code": "982499597",
            "telephone_number": "360-320-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N MAIN ST",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "982393413",
            "telephone_number": "360-914-5634",
            "fax_number": "360-678-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "CARLA",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MN, ARNP, ACHPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP30004914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coupeville, WA

Sources for this page

Verify at the official NPI Registry.