Kim D Jolly, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP2005522 Issued in FL

Practice address

3716 W Oakland Park Blvd
Lauderdale Lakes, FL 33311-1134

Phone

(954) 759-7557

Fax

(954) 733-9155

NPI assigned

Apr 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Broward Hospital DistrictGroup PAC ID 3577472422, 192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• North Broward Hospital District

  • Neurological Surgery Physician
  • Fort Lauderdale, FL
  • NPI 1801581129
  Medicare reassignment Care Compare group NPD
• North Broward Hospital District

  • Community/Retail Pharmacy
  • Pompano Beach, FL
  • NPI 1699709766
  NPD
• North Broward Hospital District

  • Community/Retail Pharmacy
  • Fort Lauderdale, FL
  • NPI 1134164965
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• North Broward Hospital District

  • General Acute Care Hospital
  • Fort Lauderdale, FL
  • NPI 1285662239
  Care Compare affiliation

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1831153733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 NW 49TH ST STE 125",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333093750",
            "telephone_number": "954-759-7557",
            "fax_number": "954-733-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 W OAKLAND PARK BLVD",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333111134",
            "telephone_number": "954-759-7557",
            "fax_number": "954-733-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "KIM",
        "middle_name": "D",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-17",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2005522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "034297100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel Frankel MD PA
• Barbara Johns, NP
• Deborah B Johnson
• Eric Marcellus Johnson
• Sierra Alecia Johnson
• Daniesha N Jones
• Kahilah Tishana Jones, LMFT
• Taniyha Jones, COTA/L
• Jessica Jordan
• Sharicka Josaphat

• Nurse Practitioner in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.