Individual provider Active NPI

Jon W Jones, MD

  • Surgery Physician
  • Johnson City, TN
National Provider Identifier
1396701405
Registry record updated Jan 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
40327 Issued in TN
Practice address
325 N State of Franklin Rd FL 3
Johnson City, TN 37604
Phone
(423) 439-7201
Fax
(423) 439-7219
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 13476 AL
Surgery Physician 208600000X 40327 TN Primary

Addresses

Primary practice location

325 N State of Franklin Rd FL 3
Johnson City, TN 37604

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 433-6039

Other practice location 1

3368 Highway 280 Ste 215
Suite 105
Alexander City, AL 35010-3375
Phone (256) 215-7479

Other identifiers 3

IdentifierTypeStateIssuer
3335017MedicaidTN
4113585OtherTNBCBS
TN01W8OtherTNJOHN DEERE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20051031000275 TN Practitioner - General Surgery 3971520867 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40327TNMDPharmacist
13476ALMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation Surgery CurrentSince Nov 1, 2017 Accepting new patients
Medical Education Assistance Corporation Surgery PastSince Nov 1, 2017 Accepting new patients
University Surgical Associates, PSC Surgery Past Accepting new patients

Locations

222 E Main St
Johnson City, TN 37604
Phone (423) 433-6200

2 Professional Park Dr
Ste 15
Johnson City, TN 37604
Phone (423) 232-4867

325 N State of Franklin Rd
Fl 3
Johnson City, TN 37604
Phone (423) 439-7201

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

Organizations & group practices 3

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1396701405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-433-6039",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N STATE OF FRANKLIN RD FL 3",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-439-7201",
            "fax_number": "423-439-7219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3368 Highway 280 Ste 215",
            "address_2": "Suite 105",
            "address_purpose": "LOCATION",
            "city": "Alexander City",
            "state": "AL",
            "postal_code": "350103375",
            "country_code": "US",
            "telephone_number": "256-215-7479",
            "fax_number": "256-329-7819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "JON",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2024-01-18",
        "certification_date": "2024-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "13476",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "40327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3335017",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4113585",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN01W8",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.