TINA JOLLY MSN, APRN, NP-C
NPI 1619412004
Nurse Practitioner - Family in Dublin, GA

Q: What is Tina Jolly's NPI number?

The NPI number for Tina Jolly is 1619412004. It was assigned to this individual provider in the NPPES registry on December 21, 2016.

Q: What is Tina Jolly's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Tina Jolly was last updated on May 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.

Active since December 21, 2016PECOS EnrolledAccepts Medicare Assignment

107 FAIRVIEW PARK DR, DUBLIN, GA 31021(478) 272-3446(478) 864-1288 Get Directions Write a Review

NPPES record last updated: May 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 22, 2025, Sep 8, 2022, May 25, 2022 and 2 more (5 updates tracked since 2016).

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About Tina Jolly Msn, Aprn, Np-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TINA JOLLY MSN, APRN, NP-C (NPI 1619412004) is an individual family provider in Dublin, Georgia, licensed in Georgia (RN139653) and active in the NPI registry since December 2016. She is enrolled in Medicare PECOS, is affiliated with Fairview Park Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1619412004

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameTINA JOLLYCredential: MSN, APRN, NP-C

Location Address107 FAIRVIEW PARK DRDublin, GA 31021-2501

Mailing AddressPo Box 317Wrightsville, GA 31096-0317 · (478) 864-3448 · Fax (478) 864-1288

Phone(478) 272-3446

Fax(478) 864-1288

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateDecember 21, 2016

Last NPPES UpdateMay 22, 20255 updates tracked since enumeration

NPPES CertifiedMay 22, 2025

✔ NPI 1619412004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN139653

107 FAIRVIEW PARK DR, Dublin, GA 31021

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Other Identifiers 3

Medicaid1619412004NC

MedicaidQ071116TN

Medicaid003151473DGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tina Jolly Msn, Aprn, Np-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID648669341

PECOS Enrollment IDI20211118002296

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880

A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.

13 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Fairview Park Hospital

Acute Care Hospitals · Dublin, GA

5/5 CMS rating

OwnershipProprietary

CMS Certification Number110125

Location200 Industrial BoulevardDublin, GA 31021 · Laurens County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 31021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DUBLIN NEPHROLOGY ASSOCIATES LLC

Internal Medicine (Nephrology)