Ryan Christopher Jolly, ATC, EMT-B

Primary specialty

Basic Emergency Medical TechnicianTaxonomy code 146N00000X

License

70108769 Issued in WI

Practice address

N1457 Hillside Rd
Lake Geneva, WI 53147-4235

Phone

(262) 248-4103

NPI assigned

Nov 21, 2017

Last updated

Nov 21, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Town of Linn

  dba Town of Linn Fire & EMS

  • Land Ambulance
  • Lake Geneva, WI
  • NPI 1093752362
  NPD (past)

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511222400000",
    "number": "1962916395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 S LAKE SHORE DR",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531472235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N1457 HILLSIDE RD",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531474235",
            "telephone_number": "262-248-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOLLY",
        "first_name": "RYAN",
        "middle_name": "CHRISTOPHER",
        "credential": "ATC, EMT-B",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-11-21",
        "last_updated": "2017-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "WI",
            "license": "70108769",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jelka, LLC
• Seon Yeop Jeong, MD
• Carling M. Johns, DPT
• Breanna Johnson
• Joint School District #1, City of Lake Geneva Et Al
• Kaiser Chiropractic, S.C.
• Christopher A Kaiser, DC
• Jennifer Frye Keefe, M.A.
• Afton Kimberly Kehl
• Cullen Timothy Kehoe, DO

• Basic Emergency Medical Technician in Lake Geneva, WI
• Providers in Lake Geneva, WI by specialty
• Basic Emergency Medical Technician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2017; 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.