Active NPI
Stanley D. Jones, M.D.
- Pediatrics Physician
- Jesup, GA
National Provider Identifier
1386614147
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 047607
- Practice address
- 391 Peachtree St
Jesup, GA 31545-0245 - Phone
- (912) 530-7337
- Fax
- (912) 530-7339
- NPI assigned
- Jan 25, 2006
- Last updated
- Nov 5, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 047607 | GA | Primary |
Addresses
Primary practice location
391 Peachtree St
Jesup, GA 31545-0245
Mailing address
391 Peachtree Street
Jesup, GA 31545-0245
Phone (912) 530-7337
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10059192 | Other | GA | AMERIGROUP |
| 000836459A | Medicaid | GA | |
| 342398 | Other | GA | WELLCARE |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047607 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neighborhood Pediatrics | Pediatrics | Past | Accepting new patients |
| Stanley D. Jones, M.D.P.C. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Blackshear, GA
- NPI 1033773858
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636070400000",
"number": "1386614147",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "391 PEACHTREE STREET",
"city": "JESUP",
"state": "GA",
"postal_code": "315450245",
"telephone_number": "912-530-7337",
"fax_number": "912-530-7339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "391 PEACHTREE ST",
"city": "JESUP",
"state": "GA",
"postal_code": "315450245",
"telephone_number": "912-530-7337",
"fax_number": "912-530-7339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "STANLEY",
"middle_name": "D.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2021-11-05",
"certification_date": "2021-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "047607",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "10059192",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000836459A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "342398",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jesup, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.