Individual provider Active NPI

Baxter William Jones, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Knoxville, TN
National Provider Identifier
1245783307
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
0000011285 Issued in TN
Practice address
111 Fox Rd Ste 201
Knoxville, TN 37922-9000
Phone
(865) 381-8867
NPI assigned
Jul 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 018.001993 IL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0000011285 TN Primary

Addresses

Primary practice location

111 Fox Rd Ste 201
Knoxville, TN 37922-9000

Mailing address

111 Fox Rd Ste 201
Knoxville, TN 37922-9000
Phone (865) 381-8867

Other practice location 1

611 W Park St
Urbana, IL 61801-2529
Phone (217) 326-1297

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161013000905 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9436447067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
018.001993ILMDOral and Maxillofacial Surgery (Dentist)
0000011285TNMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Valley Oral Surgery. PLLC Oral and Maxillofacial Surgery PastSince Mar 9, 2020 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.

NPI Registry JSON

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1245783307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FOX RD STE 201",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379229000",
            "telephone_number": "865-381-8867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FOX RD STE 201",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379229000",
            "telephone_number": "865-381-8867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 W Park St",
            "address_purpose": "LOCATION",
            "city": "Urbana",
            "state": "IL",
            "postal_code": "618012529",
            "country_code": "US",
            "telephone_number": "217-326-1297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "BAXTER",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-25",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "018.001993",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TN",
            "license": "0000011285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.