Individual provider Active NPI

Kelly Dudley Jones, APRN

  • Family Nurse Practitioner
  • Lagrange, GA
National Provider Identifier
1184935892
Registry record updated Jun 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN093051 Issued in GA
Practice address
142 Old Mill Rd
Lagrange, GA 30241-6704
Phone
(706) 885-1900
Fax
(706) 882-1350
NPI assigned
Jun 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN093051 GA Primary

Addresses

Primary practice location

142 Old Mill Rd
Lagrange, GA 30241-6704

Mailing address

142 Old Mill Rd
Lagrange, GA 30241-6704
Phone (706) 885-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101020000331 GA Practitioner - Nurse Practitioner 3678766839 Reassigns benefits to 1 organization
I20200119000040 AL Practitioner - Nurse Practitioner 3678766839 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC CurrentSince Nov 1, 2011 Accepting new patients
Rural Urgent Care LLC CurrentSince Nov 10, 2019 Accepting new patients
Rural Urgent Care LLC CurrentSince Nov 10, 2019 Accepting new patients

Locations

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

1925 W Main St
#120
Centre, AL 35960
Phone (256) 677-4552

1401 Highway 14
Millbrook, AL 36054
Phone (334) 310-6059

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277683200000",
    "number": "1184935892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 OLD MILL RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302416704",
            "telephone_number": "706-885-1900",
            "fax_number": "706-882-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 OLD MILL RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302416704",
            "telephone_number": "706-885-1900",
            "fax_number": "706-882-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "KELLY",
        "middle_name": "DUDLEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-28",
        "last_updated": "2010-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN093051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.