NPIMap

Individual provider Active NPI

Ronald Timothy Jabaley II, MD

  • Internal Medicine Physician
  • Blue Ridge, GA
National Provider Identifier
1558344994
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
050718 Issued in GA
Practice address
6 Elm St
Blue Ridge, GA 30513-2906
Phone
(706) 492-4294
Fax
(706) 492-4226
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD0000035694 TN
Internal Medicine Physician 207R00000X 050718 GA Primary
Internal Medicine Physician 207R00000X 23067 AL

Addresses

Primary practice location

6 Elm St
Blue Ridge, GA 30513-2906

Mailing address

PO Box 1058
MC Caysville, GA 30555-1058
Phone (706) 492-4294

Other identifiers 4

IdentifierTypeStateIssuer
89066FEMedicaidNC
00056372CMedicaidGA
110243133OtherRAILROAD MEDICARE
3876328MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050329000021 GA Practitioner - Internal Medicine 4486547957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6 Elm St
Blue Ridge, GA 30513-2906
Phone (706) 492-4294

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.17 of 100Reported as individual
Quality
56.35
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23067ALMDInternal Medicine Physician
MD0000035694TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emcare Physician Providers, Inc. Past Accepting new patients
Emcare Physician Providers, Inc Past Accepting new patients
Copper Basin Community Hospital Inc. Past Accepting new patients

Organizations & group practices 4

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1558344994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1058",
            "city": "MC CAYSVILLE",
            "state": "GA",
            "postal_code": "305551058",
            "telephone_number": "706-492-4294",
            "fax_number": "706-492-4226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 ELM ST",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305132906",
            "telephone_number": "706-492-4294",
            "fax_number": "706-492-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JABALEY",
        "first_name": "RONALD",
        "middle_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD0000035694",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "050718",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "23067",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89066FE",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00056372C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110243133",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3876328",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ridge, GA

Sources for this page

Verify at the official NPI Registry.