Active NPI
Kendra Denise Jones, PA
- Physician Assistant
- Marietta, GA
National Provider Identifier
1346610573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2761
- Practice address
- 711 Canton Rd NE
Suite 300
Marietta, GA 30060 - Phone
- (678) 741-5000
- Fax
- (678) 819-4280
- NPI assigned
- Sep 30, 2015
- Last updated
- May 31, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2761 | TN | Primary |
Addresses
Primary practice location
711 Canton Rd NE
Suite 300
Marietta, GA 30060
Mailing address
711 Canton Rd NE Ste 300
Marietta, GA 30060-8949
Phone (678) 741-5000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003172503A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2761 | TN | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527724800000",
"number": "1346610573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "711 CANTON RD NE STE 300",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300608949",
"telephone_number": "678-741-5000",
"fax_number": "678-819-4280"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "711 CANTON RD NE",
"address_2": "SUITE 300",
"city": "MARIETTA",
"state": "GA",
"postal_code": "30060",
"telephone_number": "678-741-5000",
"fax_number": "678-819-4280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "KENDRA",
"middle_name": "DENISE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-30",
"last_updated": "2018-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "2761",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003172503A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.