Jillian J Carolla, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP028764 Issued in PA

Practice address

1000 Commerce Park Dr Ste 110
Williamsport, PA 17701-5475

Phone

(570) 323-6944

NPI assigned

Mar 6, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Services Group IncGroup PAC ID 1052201571, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Community Services Group, Inc.

  • Community/Behavioral Health Agency
  • Mountville, PA
  • NPI 1265426084
  Medicare reassignment Care Compare group NPD
• Supportive Care of Pennsylvania LLC

  • Clinical Psychologist
  • Monsey, NY
  • NPI 1174992275

  PA

  Medicare reassignment NPD

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1487354890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 SCHOOL HOUSE LN",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178708923",
            "telephone_number": "304-785-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 COMMERCE PARK DR STE 110",
            "city": "WILLIAMSPORT",
            "state": "PA",
            "postal_code": "177015475",
            "telephone_number": "570-323-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAROLLA",
        "first_name": "JILLIAN",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN762265",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "75971",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "117947",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP028764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Rae Cappel, M.D.
• Hayli Marie Cardillo, LPC
• Patrick Joseph Carey, DO
• Caring for You, Inc.
• Carl R Albright DPM
• Mara I. Carpenter, CRNA
• Scott Carpenter, LSW, CAADC
• Richard Page Carter IV, PHARM D
• Robert Castellano
• Kristina Rebecca Castner, LPC

• Psychiatric/Mental Health Nurse Practitioner in Williamsport, PA
• Providers in Williamsport, PA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.