Active NPI
Mary Jo Jollett, CRNA
- Certified Registered Nurse Anesthetist
- Hyannis, MA
National Provider Identifier
1700851573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 122505
- Practice address
- 110 Main St
Unit B
Hyannis, MA 02601-3127 - Phone
- (508) 775-5011
- Fax
- (508) 775-4574
- NPI assigned
- Feb 23, 2006
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 122505 | MA | Primary |
Addresses
Primary practice location
110 Main St
Unit B
Hyannis, MA 02601-3127
Mailing address
110 Main St
Hyannis, MA 02601-3127
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA0748 | Other | MA | BLUE CROSS OF MA |
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
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122505 | MA | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700851573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 MAIN ST",
"city": "HYANNIS",
"state": "MA",
"postal_code": "026013127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 MAIN ST",
"address_2": "UNIT B",
"city": "HYANNIS",
"state": "MA",
"postal_code": "026013127",
"telephone_number": "508-775-5011",
"fax_number": "508-775-4574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLETT",
"first_name": "MARY JO",
"name_prefix": "Mrs.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MA",
"license": "122505",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF MA",
"identifier": "NA0748",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hyannis, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.