Active NPI
Edth Jones, PHD
- Psychologist
- Decatur, GA
National Provider Identifier
1508334723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 004249
- Practice address
- 1244 Clairmont Rd Ste 204
Decatur, GA 30030-1263 - Phone
- (404) 274-4163
- NPI assigned
- Nov 6, 2018
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 004249 | GA | Primary |
Addresses
Primary practice location
1244 Clairmont Rd Ste 204
Decatur, GA 30030-1263
Mailing address
4380 E Brookhaven Dr NE
Atlanta, GA 30319-1071
Phone (404) 274-4163
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004249 | Other | GA | GEORGIA PROFESSIONAL LICENSING BOARD |
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 Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004249 | GA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541462400000",
"number": "1508334723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4380 E BROOKHAVEN DR NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303191071",
"telephone_number": "404-274-4163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1244 CLAIRMONT RD STE 204",
"city": "DECATUR",
"state": "GA",
"postal_code": "300301263",
"telephone_number": "404-274-4163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "EDTH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-11-06",
"last_updated": "2018-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "GA",
"license": "004249",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEORGIA PROFESSIONAL LICENSING BOARD",
"identifier": "004249",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.