Samuel Jones Jr., M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

09707 Issued in MS

Practice address

102 Woodchase Park Dr
Clinton, MS 39056-4113

Phone

(601) 924-7043

Fax

(601) 924-4546

NPI assigned

Jun 29, 2006

Last updated

Apr 25, 2008By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Woodlands Rehabilitation and Healthcare Center, LLC

  • Skilled Nursing Facility
  • Clinton, MS
  • NPI 1467410449
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1245268937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123A HIGHWAY 80 E # 99",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564738",
            "telephone_number": "601-924-7043",
            "fax_number": "601-924-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 WOODCHASE PARK DR",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564113",
            "telephone_number": "601-924-7043",
            "fax_number": "601-924-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "09707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00012574",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hailee Suzanne Jones, PHARMD
• Jessica L Jones, LPC
• Kynni Addisyn Jones, FNP-BC
• Natalie Jones
• Pamela Jones
• Shelley Noelle Jones
• Thomas L Jones Jr., D.D.S.
• Robert Mark Jordan, PHARM D
• Suzanne Jourdan, PH.D.
• Luretha Kelly, LCSW

• Family Medicine Physician in Clinton, MS
• Providers in Clinton, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.