Active NPI
Kelly M Jones, D.M.D.
- Pediatric Dentistry
- Spanish Fort, AL
National Provider Identifier
1144388372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 5534
- Practice address
- 9807 McSara CT.
Spanish Fort, AL 36527 - Phone
- (251) 626-9924
- NPI assigned
- Dec 4, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5534 | AL | Primary |
Addresses
Primary practice location
9807 McSara CT.
Spanish Fort, AL 36527
Mailing address
9807 McSara CT.
Spanish Fort, AL 36527
Phone (251) 626-9924
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 812080119A | Medicaid | GA | |
| 9181143 | Other | GA | DORAL MEDICAID |
| 100200 | Other | GA | AVESIS MEDICAID |
| 102176 | Medicaid | AL |
Other names 1
- Dr. Kelly Nicole McNeil
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5534 | AL | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Malbis Parkway Pediatric Dentistry | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- Daphne, AL
- NPI 1548429160
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396828800000",
"number": "1144388372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9807 MCSARA CT.",
"city": "SPANISH FORT",
"state": "AL",
"postal_code": "36527",
"telephone_number": "251-626-9924",
"fax_number": "251-626-9984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9807 MCSARA CT.",
"city": "SPANISH FORT",
"state": "AL",
"postal_code": "36527",
"telephone_number": "251-626-9924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "KELLY",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-04",
"last_updated": "2014-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "AL",
"license": "5534",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "812080119A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DORAL MEDICAID",
"identifier": "9181143",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVESIS MEDICAID",
"identifier": "100200",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "102176",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KELLY",
"last_name": "MCNEIL",
"middle_name": "NICOLE",
"prefix": "DR.",
"credential": "DMD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Spanish Fort, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.