Individual provider Active NPI

Timothy Demetrius Jones

  • Chiropractor
  • Woodstock, GA
National Provider Identifier
1538670856
Registry record updated May 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIRO09886 Issued in GA
Practice address
301 Gold Creek TRL
Woodstock, GA 30188-5404
Phone
(770) 591-3833
NPI assigned
Oct 12, 2017
Last updated
May 8, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIRO09886 GA Primary

Addresses

Primary practice location

301 Gold Creek TRL
Woodstock, GA 30188-5404

Mailing address

2082 Winsburg Dr NW
Kennesaw, GA 30144-5224
Phone (205) 492-9285

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Peak_performance@bellsouth.net Direct

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

State licenses

LicenseStateTypeSpecialty
CHIRO09886GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan P. Snow LLC Past Accepting new patients

Organizations & group practices 1

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": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557273600000",
    "number": "1538670856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2082 WINSBURG DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301445224",
            "telephone_number": "205-492-9285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 GOLD CREEK TRL",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301885404",
            "telephone_number": "770-591-3833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "TIMOTHY",
        "middle_name": "DEMETRIUS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-12",
        "last_updated": "2019-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIRO09886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Peak_performance@bellsouth.net",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "301 Gold Creek Trl",
            "city": "Woodstock",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301885404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.