Individual provider Active NPI

Timothy Hollister Jones, MD

  • Family Medicine Physician
  • Avila Beach, CA
National Provider Identifier
1366437402
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A55265 Issued in CA
Practice address
6621 Bay Laurel PL Ste a
Avila Beach, CA 93424-3504
Phone
(805) 556-7006
Fax
(805) 439-1482
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A55265 CA Primary

Addresses

Primary practice location

6621 Bay Laurel PL Ste a
Avila Beach, CA 93424-3504

Mailing address

PO Box 159
Avila Beach, CA 93424-0159
Phone (805) 556-7006

Other identifiers 3

IdentifierTypeStateIssuer
1497116701OtherCANPI TIMOTHYJONES MD INC
A55265OtherCASTATE LICENSE
CB254654OtherPTAN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address office@regenerativemindbody.com Direct
Direct Messaging Address office@regenerativemindbody.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20120330000182 CA Practitioner - General PracticePractitioner - Family PracticePractitioner - Hospice/Palliative CarePractitioner - Emergency Medicine 7911039334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Hospice/Palliative Care
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6621 Bay Laurel PL
Suite a
Avila Beach, CA 93424-3504
Phone (805) 556-7006

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A55265CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy H. Jones, M.D., Inc. Family Medicine CurrentSince Apr 1, 2016 Accepting new patients
Emergency Medicine Associates PC Past Accepting new patients
Pacific Central Coast Health Centers Past Accepting new patients
West Penn Allegheny Health System, Inc. Past Accepting new patients
Carbon Health Medical Group of California PC Family Medicine PastSince Jun 27, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: timothy.jones@96843149934596.direct.elationemr.com

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1366437402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 159",
            "city": "AVILA BEACH",
            "state": "CA",
            "postal_code": "934240159",
            "telephone_number": "805-556-7006",
            "fax_number": "805-439-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 BAY LAUREL PL STE A",
            "city": "AVILA BEACH",
            "state": "CA",
            "postal_code": "934243504",
            "telephone_number": "805-556-7006",
            "fax_number": "805-439-1482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "TIMOTHY",
        "middle_name": "HOLLISTER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A55265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TIMOTHYJONES MD INC",
            "identifier": "1497116701",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A55265",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CB254654",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@regenerativemindbody.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "patient related information",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "6621 Bay Laurel Pl Ste A",
            "city": "Avila Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "934243504",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@regenerativemindbody.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "patient related information",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "other",
            "address_1": "6621 Bay Laurel Pl Ste A",
            "city": "Avila Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "934243504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Avila Beach, CA

Sources for this page

Verify at the official NPI Registry.