Audrey SG Jones, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23705 Issued in SC

Practice address

101 Shirley St
Pendleton, SC 29670-1824

Phone

(864) 646-7522

Fax

(864) 646-3377

NPI assigned

Jul 20, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2019 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Anmed Health

  • Pediatrics Physician
  • Anderson, SC
  • NPI 1285667824
  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1508886458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E GREENVILLE ST",
            "address_2": "SUITE 2000",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296211580",
            "telephone_number": "864-260-1590",
            "fax_number": "864-260-1596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SHIRLEY ST",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296701824",
            "telephone_number": "864-646-7522",
            "fax_number": "864-646-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "AUDREY",
        "middle_name": "SG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "23705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "237050",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Imc of South Carolina
• Innovative Vision Center LLC
• James H. Walker,III Dba Sandy Springs Family Practice
• Laura Quarterman Johnson, PHARMACIST
• Shannon Marie Johnson, NP-C
• Janice Marie Kendrick
• Baylee Klindworth
• Christina Koon, MS, RD, CSSD, LRD
• Namour Lamonica, LPC-A
• Angela Jean Langdale, RN

• All providers in Pendleton, SC
• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.