Organization Active NPI

Jones Vision Associates

  • Optometrist
  • Atlanta, GA
National Provider Identifier
1265622633
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002048 Issued in GA
Legal business name
JONES VISION ASSOCIATES
Practice address
2900 Cumberland Mall SE
Atlanta, GA 30339-8107
Phone
(770) 431-1713
NPI assigned
Jul 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Authorized official

Name
Dr. Kenneth Allen Jones, ODNPI 1265523831
Title
Owner
Phone
(770) 431-1713

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPT002048 GA Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

2900 Cumberland Mall SE
Atlanta, GA 30339-8107

Mailing address

4495 Redan CT
Smyrna, GA 30080-9318
Phone (770) 431-1713

Other identifiers 3

IdentifierTypeStateIssuer
173891OtherGASC MCARE
GRP5110OtherGAMEDICARE GRP
283422181AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040604000317 GA Part B Supplier - Clinic/Group Practice 9335121193 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

2900 Cumberland Mall SE
Atlanta, GA 30339
Phone (770) 431-1709

125 Pavilion Pkwy
Fayetteville, GA 30214
Phone (770) 460-0726

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683072000000",
    "number": "1265622633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4495 REDAN CT",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300809318",
            "telephone_number": "770-431-1713",
            "fax_number": "770-719-4392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 CUMBERLAND MALL SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303398107",
            "telephone_number": "770-431-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONES VISION ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-431-1713",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002048",
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC MCARE",
            "identifier": "173891",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP",
            "identifier": "GRP5110",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "283422181A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.