Individual provider Active NPI

Jefferson Jones, MD

  • Pediatrics Physician
  • Chamblee, GA
National Provider Identifier
1336433119
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
80232 Issued in GA
Practice address
5080 Peachtree Blvd
Suite 100
Chamblee, GA 30341-2877
Phone
(404) 785-5437
Fax
(404) 785-8053
NPI assigned
Jun 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 80232 GA Primary

Addresses

Primary practice location

5080 Peachtree Blvd
Suite 100
Chamblee, GA 30341-2877

Mailing address

5080 Peachtree Blvd
Suite 100
Chamblee, GA 30341-2877
Phone (404) 785-5437

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180726002543 GA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 5991052599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
80232GAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1336433119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 PEACHTREE BLVD",
            "address_2": "SUITE 100",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303412877",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 PEACHTREE BLVD",
            "address_2": "SUITE 100",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303412877",
            "telephone_number": "404-785-5437",
            "fax_number": "404-785-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "JEFFERSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-08",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "80232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "5080 Peachtree Blvd",
            "address_2": "Suite 100",
            "city": "Chamblee",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303412877",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chamblee, GA

Sources for this page

Verify at the official NPI Registry.