Individual provider Active NPI

Michael S Jones, PA-C

  • Physician Assistant
  • Georgetown, KY
National Provider Identifier
1689651200
Registry record updated May 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1174 Issued in KY
Practice address
101 Windsor Path
Georgetown, KY 40324-9617
Phone
(502) 868-6106
Fax
(502) 868-6107
NPI assigned
Dec 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT001524 OH
Physician Assistant 363A00000X PA1174 KY Primary

Addresses

Primary practice location

101 Windsor Path
Georgetown, KY 40324-9617

Mailing address

3480 Yorkshire Medical Park
Lexington, KY 40509-1886
Phone (859) 263-5140

Other identifiers 1

IdentifierTypeStateIssuer
7100066750MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081218000687 KY Practitioner - Physician Assistant 3678635091 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Therapy, IncGroup PAC ID 0143245415, 118 clinicians
Bluegrass Orthopaedics PSCGroup PAC ID 4789988981, 62 clinicians
H2 Rehabilitation Services of Kentucky, LLCGroup PAC ID 5799682688, shared by 7 NPIs, 187 clinicians

Practice addresses (Care Compare)

1004 Leawood Dr
Frankfort, KY 40601-3349
Phone (502) 223-7403

101 Windsor Path
Georgetown, KY 40324-9617
Phone (859) 263-5140

1868 Plaudit PL
Lexington, KY 40509-2429
Phone (859) 263-5140

193 Glades Rd
Berea, KY 40403-2261
Phone (859) 956-1055

Hospital & facility affiliations

  • Georgetown Community Hospital Hospital, Georgetown, KY, CCN 180101
  • Harrison Memorial Hospital Hospital, Cynthiana, KY, CCN 180079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
AT001524OHMDAthletic Trainer
TC074KYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bluegrass Orthopaedics PSC Physician Assistant CurrentSince Apr 1, 2016 Accepting new patients

Locations

101 Windsor Path
Georgetown, KY 40324
Phone (502) 868-6106

1868 Plaudit Pl
Lexington, KY 40509
Phone (859) 543-0002

3480 Yorkshire Medical Park
Lexington, KY 40509
Phone (859) 303-8803

Interoperability endpoints

  • Direct secure messaging: mjones287909@direct.stlukeshealth.org

Organizations & group practices 2

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 2

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": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496102400000",
    "number": "1689651200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 YORKSHIRE MEDICAL PARK",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091886",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WINDSOR PATH",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403249617",
            "telephone_number": "502-868-6106",
            "fax_number": "502-868-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2017-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "AT001524",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100066750",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, KY

Sources for this page

Verify at the official NPI Registry.