Individual provider Active NPI

Jerrel Andre Jones, DC, LMT

  • Chiropractor
  • Snellville, GA
National Provider Identifier
1689949554
Registry record updated May 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010561 Issued in GA
Practice address
1630 Scenic Hwy N Ste Y
Snellville, GA 30078-5685
Phone
(678) 400-6711
NPI assigned
Mar 12, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Reflexologist 173C00000X MT006503 GA
Massage Therapist 225700000X MT006503 GA
Chiropractor 111N00000X CHIR010561 GA Primary

Addresses

Primary practice location

1630 Scenic Hwy N Ste Y
Snellville, GA 30078-5685

Mailing address

1630 Scenic Hwy N Ste Y
Snellville, GA 30078-5685
Phone (678) 400-6711

Other practice location 1

1099 Dogwood Rd
Snellville, GA 30078-2004
Phone (404) 936-5770

Other practice location 2

3035 Five Forks Trickum Rd SW Ste 7
Lilburn, GA 30047-1874
Phone (770) 985-5223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220927002545 GA Practitioner - Chiropractic 7214313329 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MT006503GAMDReflexologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fuller Life Chiropractic Center PC Chiropractor CurrentSince Mar 3, 2025 Accepting new patients
Massage and Medspa Solutions PastSince Oct 27, 2024 Accepting new patients

Locations

40 Eastbrook Bnd
Ste C
Peachtree Cty, GA 30269
Phone (706) 646-4333

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.

NPI Registry JSON

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1689949554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 SCENIC HWY N STE Y",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785685",
            "telephone_number": "678-400-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 SCENIC HWY N STE Y",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785685",
            "telephone_number": "678-400-6711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1099 Dogwood Rd",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "300782004",
            "country_code": "US",
            "telephone_number": "404-936-5770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3035 Five Forks Trickum Rd SW Ste 7",
            "address_purpose": "LOCATION",
            "city": "Lilburn",
            "state": "GA",
            "postal_code": "300471874",
            "country_code": "US",
            "telephone_number": "770-985-5223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "JERREL",
        "middle_name": "ANDRE",
        "credential": "DC, LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-12",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173C00000X",
            "taxonomy_group": "",
            "desc": "Reflexologist",
            "state": "GA",
            "license": "MT006503",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "GA",
            "license": "MT006503",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.