Jerry L Jolley, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5706T Issued in CA

Practice address

817 Court St
Suite 10
Jackson, CA 95642-2156

Phone

(209) 223-2020

NPI assigned

Jan 26, 2006

Last updated

Dec 12, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sierra Eyecare Associates

  • Optometrist
  • Jackson, CA
  • NPI 1699854158
  NPD (past)

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1841261187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 COURT ST",
            "address_2": "SUITE 10",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422156",
            "telephone_number": "209-223-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 COURT ST",
            "address_2": "SUITE 10",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422156",
            "telephone_number": "209-223-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLEY",
        "first_name": "JERRY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "5706T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0057060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fatima Jacobo
• Denise Ann James, MFT
• Abdul Jawid
• Loni D Jay, MD
• JL Registered Nursing Home Healthcare, Inc. (Interim Healthcare Personal Care and Support Services)
• Joy's Return
• Michael W. Juby, MD
• Ming Jung, PHARMD
• K&B Pichette Enterprises, Inc. (Interim Healthcare of Amador, Calaveras and Tuolumne Counties)
• Rebecca Kaneshiro-Pacheco

• Optometrist in Jackson, CA
• Providers in Jackson, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.

Verify at the official NPI Registry.