Timothy B Jolley, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

MD00015352 Issued in WA

Practice address

1322 3Rd St SE Ste 240
Puyallup, WA 98372-3771

Phone

(253) 848-1572

Fax

(253) 841-3719

NPI assigned

Jan 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• South Hill General Medical Clinic

  • General Practice Physician
  • Puyallup, WA
  • NPI 1801827068
  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297814400000",
    "number": "1407907504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10209 136TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983743076",
            "telephone_number": "253-848-1535",
            "fax_number": "253-848-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 3RD ST SE STE 240",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723771",
            "telephone_number": "253-848-1572",
            "fax_number": "253-841-3719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "TIMOTHY",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2011-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00015352",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "MD00015352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1001502",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elyse Johnston, OTR/L
• Lisa Maureen Johnston, CCC-SLP, LICENSED
• Rhonda J. Johnston, CDP
• Frederic L Johnstone, MD
• Tena Kay Johnstone
• Paul Jon Jonas, ATC
• Nadine Kaye Jones-O'Niel
• Brittany M Jones-Renz, M.S., LMFT
• Alberto PF Jones
• Chandra Lacey Jones, AA

• General Practice Physician in Puyallup, WA
• Providers in Puyallup, WA by specialty
• General Practice Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.