Individual provider Active NPI

Farrell E Jolly, A.P.R.N., D.C.

  • Family Nurse Practitioner
  • Worcester, MA
National Provider Identifier
1780876094
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2313519 Issued in MA
Practice address
5 Neponset St
Worcester, MA 01606
Phone
(508) 595-2300
Fax
(508) 853-5226
NPI assigned
Aug 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4144 OH
Family Nurse Practitioner 363LF0000X 368105 OH
Family Nurse Practitioner 363LF0000X RN2313519 MA Primary

Addresses

Primary practice location

5 Neponset St
Worcester, MA 01606

Mailing address

5 Neponset St
Worcester, MA 01606-2714
Phone (508) 595-2300

Other practice location 1

5991 Outville Rd SW
Pataskala, OH 43062-8434
Phone (614) 558-7633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4144OHMDRegistered Dietitian
RN2313519MAMDFamily Nurse Practitioner
368105OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prima Care, PC Chiropractor CurrentSince May 1, 2017 Accepting new patients
Prima Care, PC CurrentSince May 1, 2017 Accepting new patients
Healing Well Chiropractic, LLC Chiropractor PastSince May 2, 2006 Accepting new patients

Locations

39 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 996-3311

67 Slades Ferry Ave
Somerset, MA 02726
Phone (508) 673-9400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1780876094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-595-2300",
            "fax_number": "508-853-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01606",
            "telephone_number": "508-595-2300",
            "fax_number": "508-853-5226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5991 Outville Rd SW",
            "address_purpose": "LOCATION",
            "city": "Pataskala",
            "state": "OH",
            "postal_code": "430628434",
            "country_code": "US",
            "telephone_number": "614-558-7633",
            "fax_number": "740-964-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "FARRELL",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "A.P.R.N., D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "4144",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "368105",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2313519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.