MAC EVERETT JOLLY DO
NPI 1407542384
General Practice in Conway, SC
About Mac Everett Jolly Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MAC EVERETT JOLLY DO (NPI 1407542384) is an individual general practice provider in Conway, South Carolina, licensed in Arizona (011162) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mac Everett Jolly Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mac Jolly reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Dallas, TX 75244
- Reassigned Medicare billing, Arizona enrollment
- 556 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 11
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CONWAY, SC 29526
CONWAY, SC 29526
CONWAY, SC 29526
CONWAY, SC 29526
CONWAY, SC 29526
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mac Jolly's NPI number?
The NPI number for Mac Jolly is 1407542384. It was assigned to this individual provider in the NPPES registry on April 13, 2023.
Where is Mac Jolly located?
Mac Jolly practices at 300 Singleton Ridge Road, Conway, SC 29526. The listed phone number is (843) 347-8134.
What is Mac Jolly's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Mac Jolly enrolled in Medicare?
Yes. Mac Jolly is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mac Jolly's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mac Jolly reassigns Medicare benefits to Signify Health, LLC (Dallas, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mac Jolly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mac Jolly was last updated on August 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mac Everett Jolly, DO · NPI 1407542384
General Practice physician in Conway, South Carolina. Individual provider, active in the CMS NPPES registry since April 13, 2023.
## Identity
- **NPI:** 1407542384 (Entity type: Individual)
- **Enumerated:** April 13, 2023
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **State license:** 011162 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 300 SINGLETON RIDGE ROAD, Conway, SC 29526-9142
- **Phone:** (843) 347-8134
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Signify Health, LLC (NPI 1689158487, Dallas, TX), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 1, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1407542384) · Data from the CMS NPPES public registry.