Bryan Gregory Jollay

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

738 Mercer St
Princeton, WV 24740-3114

Phone

(304) 323-3069

NPI assigned

Jan 11, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Princeton Community Homecare, LLC

  • Home Health Agency
  • Princeton, WV
  • NPI 1861527715
  NPD
• Princeton Community Homecare, LLC

  • Home Health Agency
  • Princeton, WV
  • NPI 1770971004
  NPD (past)

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1790499002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 LORETTO DR",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243822084",
            "telephone_number": "304-809-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 MERCER ST",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247403114",
            "telephone_number": "304-323-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLAY",
        "first_name": "BRYAN",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-11",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "desktop/tablet",
            "affiliation": "N",
            "address_1": "738 Mercer St",
            "city": "Princeton",
            "state": "WV",
            "country_code": "US",
            "postal_code": "247403114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eugene F Johnson Jr., D.O.
• Izabella Johnson, BS
• Jennifer Leigh Johnson, AADC
• Kathy Johnson
• Michael Johnson, M.ED.
• Jon M. Lovern DDS PLLC
• Areona Jones
• Brooklyn Nicole Jones, PHYSICIAN ASSISTANT
• Robert March Jones Jr., MD
• Samantha Jones, PR

• Physical Therapist in Princeton, WV
• Providers in Princeton, WV by specialty
• Physical Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.