Individual provider Active NPI

Harley Kemp Jones Jr., O.D.

  • Optometrist
  • Swainsboro, GA
National Provider Identifier
1043222805
Registry record updated Sep 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT000827 Issued in GA
Practice address
803 French St
Swainsboro, GA 30401-5523
Phone
(706) 551-9553
NPI assigned
Aug 12, 2006
Last updated
Sep 5, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT000827 GA Primary

Addresses

Primary practice location

803 French St
Swainsboro, GA 30401-5523

Mailing address

803 French St
Swainsboro, GA 30401-5523
Phone (706) 551-9553

Other identifiers 1

IdentifierTypeStateIssuer
000136804EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000467 GA Practitioner - Optometry 4688689037 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT000827GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jul 11, 2014 Accepting new patients
Myeyedr Optometry of Georgia, LLC Optometrist CurrentSince Jul 11, 2014 Accepting new patients
Mobile Medical Eye Care LLC Optometrist CurrentSince May 26, 2021 Accepting new patients
Gayton Health Centre, PC PastSince Aug 1, 2021 Accepting new patients

Locations

4875 Altama Ave
Brunswick, GA 31520
Phone (912) 554-0010

1014 Northside Dr E
Statesboro, GA 30458
Phone (912) 764-9147

342 W Main St
Swainsboro, GA 30401
Phone (478) 237-5909

12910 Shelbyville Rd
Ste 128
Louisville, KY 40243

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599264000000",
    "number": "1043222805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 FRENCH ST",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304015523",
            "telephone_number": "706-551-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 FRENCH ST",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304015523",
            "telephone_number": "706-551-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "HARLEY",
        "middle_name": "KEMP",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2020-09-05",
        "certification_date": "2020-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000136804E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Swainsboro, GA

Sources for this page

Verify at the official NPI Registry.