Individual provider Active NPI

Joseph F Jolly, M.D.

  • Pediatrics Physician
  • Alabaster, AL
National Provider Identifier
1477579076
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
00020801 Issued in AL
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

Updated by the provider on Jan 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
12-10100OtherALUNITED HEALTHCARE
5107567OtherALAETNA
51514832OtherALBLUE CROSS BLUE SHIELD
009941473MedicaidAL
33674OtherALHEALTHSPRING
G61312OtherALVIVA 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

LicenseStateTypeSpecialty
00020801ALMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew 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

  • Direct secure messaging: 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.

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.

Verify at the official NPI Registry.