Jose R Justiniano-Ayala, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

46773 Issued in GA

Practice address

205 Jenkins Rd
Rossville, GA 30741

Phone

(706) 866-5520

Fax

(706) 866-5502

NPI assigned

Feb 15, 2006

Last updated

Jun 19, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jose.justiniano.ayala@gadirect.net

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.

• Primary Health Care Center of Dade, Inc.

  • Federally Qualified Health Center (FQHC)
  • Trenton, GA
  • NPI 1437102449
  NPD
• Hutcheson Primary Care, LLC

  • Family Medicine Physician
  • Chickamauga, GA
  • NPI 1992751747
  NPD (past)

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1831163898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13570 N MAIN ST",
            "city": "TRENTON",
            "state": "GA",
            "postal_code": "307522012",
            "telephone_number": "706-866-5520",
            "fax_number": "706-866-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 JENKINS RD",
            "city": "ROSSVILLE",
            "state": "GA",
            "postal_code": "30741",
            "telephone_number": "706-866-5520",
            "fax_number": "706-866-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTINIANO-AYALA",
        "first_name": "JOSE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "46773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Jenkins
• Dana Gae Johnson, CADCII, CCS
• Kirstin Joanna Johnson
• Snezana Brady Johnson, CADCII
• Daniel W. Jordan, LADAC II, CADC II
• K-VA-T Food Stores Inc (Food City Pharmacy #217)
• Aaron Michael Kirkpatrick, OTR
• Julie Lynn Kubin, COTA/L
• Kimberly Langford, OTA
• Alma Ann Larkin Huff, LCSW

• Family Medicine Physician in Rossville, GA
• Providers in Rossville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.