Individual provider Active NPI

Shavon L Jones

  • Prosthetics Case Management
  • Stone Mountain, GA
National Provider Identifier
1083351019
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
Practice address
4762 Lost Colony CT
Stone Mountain, GA 30088-3522
Phone
(267) 370-6972
Fax
(404) 994-7006
NPI assigned
May 20, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotic Fitter 225000000X GA
Prosthetics Case Management 1744P3200X GA Primary

Addresses

Primary practice location

4762 Lost Colony CT
Stone Mountain, GA 30088-3522

Mailing address

4762 Lost Colony CT
Stone Mountain, GA 30088-3522
Phone (267) 370-6972

Other identifiers 1

IdentifierTypeStateIssuer
881612487OtherGACRANIAL PROSTHESIS

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

NPI Registry JSON

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1083351019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4762 LOST COLONY CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300883522",
            "telephone_number": "267-370-6972",
            "fax_number": "404-994-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4762 LOST COLONY CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300883522",
            "telephone_number": "267-370-6972",
            "fax_number": "404-994-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SHAVON",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225000000X",
            "taxonomy_group": "",
            "desc": "Orthotic Fitter",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRANIAL PROSTHESIS",
            "identifier": "881612487",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.