Individual provider Active NPI

Jeffrey Kenneth Kingsley, D.O.

  • Family Medicine Physician
  • Columbus, GA
National Provider Identifier
1720019508
Registry record updated Jul 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
052973 Issued in GA
Practice address
800 Talbotton Rd
Columbus, GA 31904
Phone
(706) 596-4894
Fax
(706) 320-0629
NPI assigned
Jul 6, 2006
Last updated
Jul 24, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 052973 GA Primary

Addresses

Primary practice location

800 Talbotton Rd
Columbus, GA 31904

Mailing address

800 Talbotton Rd
Columbus, GA 31904
Phone (706) 596-4894

Other identifiers 1

IdentifierTypeStateIssuer
252539178AMedicaidGA

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 Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
052973GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Associates LLC Family Medicine Past Accepting new patients
Southland Medical Solutions of Eufaula, PL Past Accepting new patients
Paragon Contracting Services LLC Past Accepting new patients
Regional Urgent Care Center, LLC Family Medicine Past Accepting new patients
Columbus Ambulatory Healthcare Services, Inc. Family Medicine PastSince Oct 31, 2021 Accepting new patients
Southland Hospitalist at Ozark, PL Past Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1720019508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 TALBOTTON RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-596-4894",
            "fax_number": "706-320-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 TALBOTTON RD",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-596-4894",
            "fax_number": "706-320-0629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINGSLEY",
        "first_name": "JEFFREY",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "052973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "252539178A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.