Active NPI
Kevin T. Jones, PH.D.
- Clinical Psychologist
- Baytown, TX
National Provider Identifier
1619904778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 23455
- Practice address
- 4721 Garth Rd
Suite a-300
Baytown, TX 77521-2153 - Phone
- (281) 427-1115
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 23455 | TX | Primary |
Addresses
Primary practice location
4721 Garth Rd
Suite a-300
Baytown, TX 77521-2153
Mailing address
4721 Garth Rd
Suite a-300
Baytown, TX 77521-2153
Phone (281) 427-1115
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680007408 | Other | TX | RAIL ROAD |
| 128059601 | Medicaid | TX | |
| 128059602 | Medicaid | TX | |
| 128059603 | Medicaid | TX | |
| P000DX100 | Medicaid | TX | |
| 86111A | Other | TX | BLUE CROSS BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23455 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1619904778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4721 GARTH RD",
"address_2": "SUITE A-300",
"city": "BAYTOWN",
"state": "TX",
"postal_code": "775212153",
"telephone_number": "281-427-1115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4721 GARTH RD",
"address_2": "SUITE A-300",
"city": "BAYTOWN",
"state": "TX",
"postal_code": "775212153",
"telephone_number": "281-427-1115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "KEVIN",
"middle_name": "T.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "23455",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD",
"identifier": "680007408",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128059601",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128059602",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128059603",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "P000DX100",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "86111A",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baytown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.