Walter Gene Jines, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2158 Issued in AR

Practice address

12501 Cantrell Road
Little Rock, AR 72223

Phone

(501) 223-3838

Fax

(501) 223-2554

NPI assigned

Nov 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• W Gene Jines Professional name

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Heathman Family Dental Inc

  • Dental Clinic/Center
  • Little Rock, AR
  • NPI 1700094786

  General Practice

  NPD (past)
• Montgomery Heathman DDS, PA

  • Dentist
  • Little Rock, AR
  • NPI 1851750897
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386714178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 CANTRELL ROAD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72223",
            "telephone_number": "501-223-3838",
            "fax_number": "501-223-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 CANTRELL ROAD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72223",
            "telephone_number": "501-223-3838",
            "fax_number": "501-223-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JINES",
        "first_name": "WALTER",
        "middle_name": "GENE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102068608",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL OF AR",
            "identifier": "2158",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR LUE CROSS BLUE SHIELD",
            "identifier": "58928",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "617338",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "W",
            "last_name": "JINES",
            "middle_name": "GENE",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jimmerson Family Health Care P.a.
• Kayla Jimmerson
• Robert Tyray Jimmerson II, M.D.
• Aparna Jindal, MD
• Ravi Jindal, MBBS DNB
• JK Williamson Consulting
• JLM Ventures, Inc.
• JLM Ventures, Inc.
• Joe B. Pevahouse M.D. P.a
• Joe F Bradley Mdpa

• General Practice Dentistry in Little Rock, AR
• Providers in Little Rock, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.