Individual provider Active NPI

Andrea L Jones, PA-C

  • Physician Assistant
  • Prestonsburg, KY
National Provider Identifier
1396837548
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1189 Issued in KY
Practice address
4851 Ky Route 321
Prestonsburg, KY 41653
Phone
(606) 886-1173
Fax
(606) 886-2193
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110002383 VA
Physician Assistant 363A00000X PA1189 KY Primary

Addresses

Primary practice location

4851 Ky Route 321
Prestonsburg, KY 41653

Mailing address

PO Box 697
Prestonsburg, KY 41653-0697
Phone (606) 886-1173

Other practice location 1

713 Broadway St
Suite 301
Paintsville, KY 41240-1465
Phone (606) 789-2427

Other practice location 2

713 Broadway St
Suite 301
Paintsville, KY 41240-1465
Phone (606) 789-2427

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
I20151005002069 KY Practitioner - Physician Assistant 5294733184 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Frontier Medical Associates of Prestonsburg IncGroup PAC ID 8123436219, 17 clinicians
Frontier Medical Associates of Paintsville IncGroup PAC ID 2961820337, 13 clinicians

Practice addresses (Care Compare)

400 University Dr
Prestonsburg, KY 41653-1080
Phone (606) 886-6622

713 Broadway St
Paintsville, KY 41240-1465
Phone (606) 372-1234

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA1189KYMDPhysician Assistant
0110002383VAMDPhysician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1396837548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 697",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416530697",
            "telephone_number": "606-886-1173",
            "fax_number": "606-886-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 KY ROUTE 321",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "41653",
            "telephone_number": "606-886-1173",
            "fax_number": "606-886-2193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "713 Broadway St",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "Paintsville",
            "state": "KY",
            "postal_code": "412401465",
            "country_code": "US",
            "telephone_number": "606-789-2427",
            "fax_number": "606-789-1538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "713 Broadway St",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "Paintsville",
            "state": "KY",
            "postal_code": "412401465",
            "country_code": "US",
            "telephone_number": "606-789-2427",
            "fax_number": "606-789-1538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "ANDREA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002383",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prestonsburg, KY

Sources for this page

Verify at the official NPI Registry.