Active NPI
Joseph F Jolly, M.D.
- Pediatrics Physician
- Alabaster, AL
National Provider Identifier
1477579076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 00020801
- Practice address
- 1022 1St St N
Suite 102
Alabaster, AL 35007-8706 - Phone
- (205) 663-9550
- Fax
- (205) 620-0864
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 00020801 | AL | Primary |
Addresses
Primary practice location
1022 1St St N
Suite 102
Alabaster, AL 35007-8706
Mailing address
1022 1St St N
Suite 102
Alabaster, AL 35007-8706
Phone (205) 663-9550
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12-10100 | Other | AL | UNITED HEALTHCARE |
| 5107567 | Other | AL | AETNA |
| 51514832 | Other | AL | BLUE CROSS BLUE SHIELD |
| 009941473 | Medicaid | AL | |
| 33674 | Other | AL | HEALTHSPRING |
| G61312 | Other | AL | VIVA HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00020801 | AL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Children'S Hospital of Alabama | Pediatrics | Past | Accepting new patients |
| The Children'S Hospital of Alabama | Past | Accepting new patients | |
| The Children'S Hospital of Alabama | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- jjolly20570@childrensofalabama.direct-ci.com
Organizations & group practices 3
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.
-
- Pediatrics Physician
- Hueytown, AL
- NPI 1104903749
-
- Pediatrics Physician
- Hoover, AL
- NPI 1124105762
-
- Children's Hospital
- Birmingham, AL
- NPI 1205935012
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451865600000",
"number": "1477579076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1022 1ST ST N",
"address_2": "SUITE 102",
"city": "ALABASTER",
"state": "AL",
"postal_code": "350078706",
"telephone_number": "205-663-9550",
"fax_number": "205-620-0864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1022 1ST ST N",
"address_2": "SUITE 102",
"city": "ALABASTER",
"state": "AL",
"postal_code": "350078706",
"telephone_number": "205-663-9550",
"fax_number": "205-620-0864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLY",
"first_name": "JOSEPH",
"middle_name": "F",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2016-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "00020801",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "12-10100",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5107567",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "51514832",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009941473",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSPRING",
"identifier": "33674",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIVA HEALTH",
"identifier": "G61312",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Alabaster, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.