Active NPI
Janine Jolly, PMHNP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Lincolnton, NC
National Provider Identifier
1629533831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 5011417
- Practice address
- 212 Gamble Dr
Lincolnton, NC 28092 - Phone
- (704) 735-7145
- NPI assigned
- Feb 1, 2019
- Last updated
- Oct 21, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 5011417 | NC | Primary |
Addresses
Primary practice location
212 Gamble Dr
Lincolnton, NC 28092
Mailing address
200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-0567
Other practice location 1
2365 Springs Rd NE
Hickory, NC 28601-3067
Other practice location 2
212 Gamble Dr
Lincolnton, NC 28092
Phone (704) 735-7145
Other practice location 3
133 1st Ave SE
Hickory, NC 28602-3005
Phone (828) 994-4544
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5011417 | NC | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571616000000",
"number": "1629533831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E 2ND AVE",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280524358",
"telephone_number": "704-874-0567",
"fax_number": "704-864-7608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 GAMBLE DR",
"city": "LINCOLNTON",
"state": "NC",
"postal_code": "28092",
"telephone_number": "704-735-7145"
}
],
"practiceLocations": [
{
"address_1": "2365 Springs Rd NE",
"address_purpose": "LOCATION",
"city": "Hickory",
"state": "NC",
"postal_code": "286013067",
"country_code": "US",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "212 Gamble Dr",
"address_purpose": "LOCATION",
"city": "Lincolnton",
"state": "NC",
"postal_code": "28092",
"country_code": "US",
"telephone_number": "704-735-7145",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "133 1st Ave SE",
"address_purpose": "LOCATION",
"city": "Hickory",
"state": "NC",
"postal_code": "286023005",
"country_code": "US",
"telephone_number": "828-994-4544",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOLLY",
"first_name": "JANINE",
"credential": "PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-01",
"last_updated": "2019-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "NC",
"license": "5011417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincolnton, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.