Active NPI
Benjamin Dean Jolley, PHARMD
- Ambulatory Care Pharmacist
- Salt Lake City, UT
National Provider Identifier
1831703198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Pharmacist
- License
- 7050817-1701
- Practice address
- 1702 S 1100 E
Salt Lake City, UT 84105-3424 - Phone
- (801) 484-4393
- Fax
- (801) 484-8677
- NPI assigned
- Sep 3, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Pharmacist | 1835P2201X | 7050817-1701 | UT | Primary |
| Diabetes Educator Registered Nurse | 163WD0400X | 7050817-1701 | UT |
Addresses
Primary practice location
1702 S 1100 E
Salt Lake City, UT 84105-3424
Mailing address
1702 S 1100 E
Salt Lake City, UT 84105-3424
Phone (801) 484-4393
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7050817-1701 | Other | UT | STATE PHARMACIST LICENSE |
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7050817-1701 | UT | MD | Diabetes Educator Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jolley Comp and Specialty Pham | Current | Accepting new patients |
Locations
1702 S 1100 E
Salt Lake City, UT 84105
Phone (801) 484-4393
Organizations & group practices 1
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.
-
- Community/Retail Pharmacy
- Salt Lake City, UT
- NPI 1659445187
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619136000000",
"number": "1831703198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1702 S 1100 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841053424",
"telephone_number": "801-484-4393",
"fax_number": "801-484-8677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1702 S 1100 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841053424",
"telephone_number": "801-484-4393",
"fax_number": "801-484-8677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLEY",
"first_name": "BENJAMIN",
"middle_name": "DEAN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-03",
"last_updated": "2021-04-23",
"certification_date": "2021-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "1835P2201X",
"taxonomy_group": "",
"desc": "Pharmacist, Ambulatory Care",
"state": "UT",
"license": "7050817-1701",
"primary": true
},
{
"code": "163WD0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Diabetes Educator",
"state": "UT",
"license": "7050817-1701",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACIST LICENSE",
"identifier": "7050817-1701",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.