Individual provider Active NPI

Jimmy Dale Jones

  • Occupational Therapy Assistant
  • Galax, VA
National Provider Identifier
1639635626
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0131000925 Issued in VA
Practice address
202 Painter St
Galax, VA 24333
Phone
(276) 236-5164
NPI assigned
Feb 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 0131000925 VA Primary

Addresses

Primary practice location

202 Painter St
Galax, VA 24333

Mailing address

202 Painter St
Galax, VA 24333-3830
Phone (276) 236-5164

Other practice location 1

202 Painter St
Galax, VA 24333
Phone (276) 236-5164

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
0131000925VAMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1639635626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 PAINTER ST",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "243333830",
            "telephone_number": "276-236-5164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 PAINTER ST",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "24333",
            "telephone_number": "276-236-5164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 Painter St",
            "address_purpose": "LOCATION",
            "city": "Galax",
            "state": "VA",
            "postal_code": "24333",
            "country_code": "US",
            "telephone_number": "276-236-5164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "JIMMY",
        "middle_name": "DALE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131000925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 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.