NPIMap

Organization Active NPI

Jones Family Medicine Clinic PLLC

  • Primary Care Clinic/Center
  • Laurel, MS
National Provider Identifier
1841385168
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
JONES FAMILY MEDICINE CLINIC PLLC
Practice address
30 Circle J Dr
Ste 1
Laurel, MS 39440-1980
Phone
(601) 425-0092
Fax
(601) 425-0473
NPI assigned
Oct 3, 2006
Last updated
Dec 15, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Authorized official

Name
Kaye D. Jones
Title
Business Manager
Phone
(601) 425-0092

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

30 Circle J Dr
Ste 1
Laurel, MS 39440-1980

Mailing address

30 Circle J Dr
Ste 1
Laurel, MS 39440-1980
Phone (601) 425-0092

Other identifiers 1

IdentifierTypeStateIssuer
08706882MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050921000315 MS Part B Supplier - Clinic/Group Practice 6406880368 Receives reassigned benefits from 24 practitioners
5 other NPIs on this enrollment
Practice locations: Bay Springs, MS; Quitman, MS; Laurel, MS; Heidelberg, MS; Ellisville, MS

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
JFMC Heidelberg LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2680 Highway 15
Bay Springs, MS 39422
Phone (601) 764-6972

235 S 14th Ave
Laurel, MS 39440
Phone (601) 425-0092

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1841385168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CIRCLE J DR",
            "address_2": "STE 1",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401980",
            "telephone_number": "601-425-0092",
            "fax_number": "601-425-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CIRCLE J DR",
            "address_2": "STE 1",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401980",
            "telephone_number": "601-425-0092",
            "fax_number": "601-425-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONES FAMILY MEDICINE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KAYE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "601-425-0092"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08706882",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.