Robert Tyre Jones IV, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY002625 Issued in GA

Practice address

1397 Manchester Dr NE
Conyers, GA 30012-3882

Phone

(770) 483-6377

Fax

(770) 929-0902

NPI assigned

Dec 21, 2006

Last updated

Sep 18, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Aug 27, 2018 through Aug 27, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1225192479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1397 MANCHESTER DR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123882",
            "telephone_number": "770-483-6377",
            "fax_number": "770-929-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 MANCHESTER DR NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123882",
            "telephone_number": "770-483-6377",
            "fax_number": "770-929-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "ROBERT",
        "middle_name": "TYRE",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY002625",
            "primary": true
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "GA",
            "license": "PSY002625",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tashira Jones Hamler, RN
• Ameari Jones, RBT
• Constance Joy Jones, DPT
• Denesha Jones, RBT
• Derianne' Amber Jones, FPMHNP
• Samuel Chadwick Jones, M.S.
• Shantana Laquanda Jones
• Shaunda Ayana Jones
• Tiffany Jones
• Valorie Antoinette Jones, LPC, CRC

• Clinical Psychologist in Conyers, GA
• Providers in Conyers, GA by specialty
• Clinical Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.