Active NPI
Louis Jolley
- Driver
- Woodbridge, VA
National Provider Identifier
1982051876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- D06287776
- Practice address
- 16040 Imperial Eagle CT
Woodbridge, VA 22191-6559 - Phone
- (678) 542-5003
- NPI assigned
- May 20, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | D06287776 | AZ | Primary |
Addresses
Primary practice location
16040 Imperial Eagle CT
Woodbridge, VA 22191-6559
Mailing address
16040 Imperial Eagle Court
Wodbridge, VA 22191
Phone (678) 542-5003
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D06287776 | AZ | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463702400000",
"number": "1982051876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16040 IMPERIAL EAGLE COURT",
"city": "WODBRIDGE",
"state": "VA",
"postal_code": "22191",
"telephone_number": "678-542-5003"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16040 IMPERIAL EAGLE CT",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221916559",
"telephone_number": "678-542-5003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOLLEY",
"first_name": "LOUIS",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-20",
"last_updated": "2016-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "AZ",
"license": "D06287776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.