RYAN CHRISTOPHER JOLLY (NPI# 1962916395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962916395 |
| Entity Type | Individual |
| Full Name | RYAN CHRISTOPHER JOLLY |
| Credential | ATC, EMT-B |
| Practice Address |
N1457 Hillside Rd Lake Geneva WI 53147-4235 |
| Mailing Address |
1028 S Lake Shore Dr Lake Geneva WI 53147-2235 |
| Practice Telephone | 2622484103 |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 146N00000X | Emergency Medical Technician, Basic | 70108769 | WI | Emergency Medical Service Providers |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
N1457 HILLSIDE RD |
| City | LAKE GENEVA |
| State | WI |
| Zip Code | 53147-4235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093752362 | Town of Linn | Ambulance | N1457 Hillside Rd, Lake Geneva, WI 53147-4235 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356951206 | Emily Tanis | Physical Therapist | 6722 Wi-50, Lake Geneva, WI 53147 | 2020-08-05 |
| 1588295653 | Baylee M Noe | Occupational Therapy Assistant | Sage Meadow of Lake Geneva 6722 Wi-50, Lake Geneva, WI 53147 | 2020-01-28 |
| 1124539556 | Roxanne Weber | Registered Nurse | 146 E. Geneva Square, Lake Geneva, WI 53147 | 2017-10-12 |
| 1386969400 | Emily Kathleen Wilczak | Surgery | N2950 Wi-67, Lake Geneva, WI 53147 | 2010-03-31 |
| 1538294020 | Dale Alan Miller | Pharmacist | 2950 St. Hwy. 67, Lake Geneva, WI 53147 | 2007-02-23 |
| 1689779902 | Balistreri & Associates Physical Therapy | Physical Therapist | 902 Wells Street, Lake Geneva, WI 53147 | 2006-09-13 |
| 1336157981 | Nestor C Alabarca | Internal Medicine | 146 E Geneva Square, Lake Geneva, WI 53147 | 2006-08-03 |
| 1144259375 | Kim M. Cuculi | Occupational Therapist | 800 Geneva Pkwy N Ste 3, Lake Geneva, WI 53147 | 2006-07-01 |
| 1396253571 | Amar Y. Patel | Family Medicine | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2018-01-22 |
| 1679017925 | Christina L. Clancy | Nurse Practitioner | 146 E Geneva Sq, Lake Geneva, WI 53147 | 2016-12-06 |
| Find all providers in zip 53147 | ||||
| Taxonomy Code | 146N00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Basic |
| A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487251575 | Ronald Mesha Hardwick Jr. | Emergency Medical Technician, Basic | 263 S Marr St, Fond Du Lac, WI 54935-5075 | 2020-10-02 |
| 1245849850 | William M Icard Jr. | Emergency Medical Technician, Basic | 1679 County Road H, Deer Park, WI 54007-7102 | 2020-07-29 |
| 1497374516 | Austin Chronister | Emergency Medical Technician, Basic | 3022 W State St, Milwaukee, WI 53208-3459 | 2020-04-09 |
| 1043778228 | Rita Marie Acosta | Emergency Medical Technician, Basic | 509 University Dr, Mcphee Atr, Eau Claire, WI 54701 | 2019-03-07 |
| 1669961124 | Duffy David Eberhardt | Emergency Medical Technician, Basic | N7936 Woody Ln, Ixonia, WI 53036-9479 | 2018-05-09 |
| 1346737822 | Paul Christopher Usher Jr. | Emergency Medical Technician, Basic | 2226 S 89th St Apt 8, West Allis, WI 53227-1659 | 2018-04-19 |
| 1679004030 | Montello Joint Fire District | Emergency Medical Technician, Basic | 20 Underwood Ave, Montello, WI 53949-9259 | 2017-03-27 |
| 1992192546 | Kaylee Craigo | Emergency Medical Technician, Basic | N2081 Alphorn Rd, Monroe, WI 53566-8921 | 2015-04-21 |
| 1629485982 | Said Aden | Emergency Medical Technician, Basic | 234 W Florida S Suite 311, Milwaukee, WI 53204-1659 | 2014-07-18 |
| 1306149208 | Cassville Volunteer Fire Dept and Rescue Squad | Emergency Medical Technician, Basic | 310 W. Amelia Street, Cassville, WI 53806-9735 | 2010-12-15 |
| Find all providers with the same taxonomy | ||||
| City | LAKE GENEVA |
| Zip Code | 53147 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.