Holly Kay Jodon, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA000632L Issued in PA

Practice address

240 W 11TH St
2ND Floor
Erie, PA 16501-1702

Phone

(814) 452-2218

Fax

(814) 452-4639

NPI assigned

Mar 28, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237766400000",
    "number": "1861453268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 W 11TH ST",
            "address_2": "2ND FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011702",
            "telephone_number": "814-452-2218",
            "fax_number": "814-452-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W 11TH ST",
            "address_2": "2ND FLOOR",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165011702",
            "telephone_number": "814-452-2218",
            "fax_number": "814-452-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JODON",
        "first_name": "HOLLY",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-28",
        "last_updated": "2009-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA000632L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Physician Assistant in Erie, PA
• Providers in Erie, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.