Individual provider Active NPI

Robert Joseph Jones, PA-C

  • Physician Assistant
  • Marion, KY
National Provider Identifier
1376536870
Registry record updated Mar 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA685 Issued in KY
Practice address
520 W Gum St
Marion, KY 42064-1516
Phone
(270) 965-5281
Fax
(270) 965-1161
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA685 KY Primary

Addresses

Primary practice location

520 W Gum St
Marion, KY 42064-1516

Mailing address

402 Maple St
Eddyville, KY 42038-8037
Phone (270) 388-5404

Other identifiers 1

IdentifierTypeStateIssuer
95002838MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071017000794 KY Practitioner - Physician Assistant 6204851074 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky Em-I Medical Services PSC Physician Assistant CurrentSince Feb 18, 2021 Accepting new patients
Hopkinsville Emergency Physicians LLC Past Accepting new patients
Kentucky Em-I Medical Services PSC Physician Assistant Past Accepting new patients
Emergency Physicians of Hopkinsville PLLC Past Accepting new patients

Locations

1801 Ashley Cir
Bowling Green, KY 42104
Phone (270) 781-4330

803 Poplar St
Murray, KY 42071
Phone (270) 762-1155

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.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205366400000",
    "number": "1376536870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 MAPLE ST",
            "city": "EDDYVILLE",
            "state": "KY",
            "postal_code": "420388037",
            "telephone_number": "270-388-5404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W GUM ST",
            "city": "MARION",
            "state": "KY",
            "postal_code": "420641516",
            "telephone_number": "270-965-5281",
            "fax_number": "270-965-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "ROBERT",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2008-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95002838",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, KY

Sources for this page

Verify at the official NPI Registry.