Individual provider Active NPI

Alexa Jolles, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Plymouth, MA
National Provider Identifier
1528645314
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2389678 Issued in MA
Practice address
61 Industrial Park Rd Ste 1
Plymouth, MA 02360-7246
Phone
(508) 830-1234
NPI assigned
Mar 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2389678 MA Primary
Registered Nurse 163W00000X RN2389678 MA

Addresses

Primary practice location

61 Industrial Park Rd Ste 1
Plymouth, MA 02360-7246

Mailing address

61 Industrial Park Rd Ste 1
Plymouth, MA 02360-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240612002580 MA Practitioner - Nurse Practitioner 8224570627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
High Point Treatment Center IncGroup PAC ID 3779578174, 41 clinicians

Practice addresses (Care Compare)

61 Industrial Park Rd
Plymouth, MA 02360-7246
Phone (508) 830-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
High Point Treatment Center Inc. CurrentSince Jun 10, 2024 Accepting new patients

Locations

72 Kilburn St
New Bedford, MA 02740
Phone (774) 213-8448

61 Industrial Park Rd
Plymouth, MA 02360
Phone (508) 746-8977

1233 State Rd
Plymouth, MA 02360
Phone (508) 224-6527

61 Industrial Park Rd
Ste 1
Plymouth, MA 02360
Phone (508) 830-1234

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1528645314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 INDUSTRIAL PARK RD STE 1",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023607246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 INDUSTRIAL PARK RD STE 1",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023607246",
            "telephone_number": "508-830-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLES",
        "first_name": "ALEXA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2389678",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2389678",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.