Jill M Jolley, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

010802 Issued in NY

Practice address

1900 Ridge Rd
West Seneca, NY 14224-3332

Phone

(716) 712-0670

Fax

(716) 712-0674

NPI assigned

Apr 28, 2006

Last updated

Sep 23, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jill M Wiech Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1548227879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 RIDGE RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243332",
            "telephone_number": "716-712-0670",
            "fax_number": "716-716-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 RIDGE RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142243332",
            "telephone_number": "716-712-0670",
            "fax_number": "716-712-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052482",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "010802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "WIECH",
            "middle_name": "M",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maralynn Johnson, MASSAGE THERAPIST
• Rurik Johnson
• Sharon Jayne Johnson, LCSW
• Taylor Paige Johnson, M.D.
• Sabrina Renae Johnston
• Nyles Jones
• Wayne A Jones, CRNA
• Amy Marie Jordan, FNP
• William Richard Josefiak
• Joseph F Biasillo DC LLP

• Physician Assistant in West Seneca, NY
• Providers in West Seneca, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2010; 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.