Individual provider Active NPI

Carla Bernita Jones, LPN

  • Licensed Practical Nurse
  • Atlanta, GA
National Provider Identifier
1891032157
Registry record updated Jan 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN059388 Issued in GA
Practice address
2064 Ridgedale Rd NE
Atlanta, GA 30317
Phone
(888) 719-5445
Fax
(678) 805-4743
NPI assigned
Jan 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN059388 GA Primary
Licensed Vocational Nurse 164X00000X LPN059388 GA
Religious Nonmedical Practitioner 374K00000X LPN059388 GA

Addresses

Primary practice location

2064 Ridgedale Rd NE
Atlanta, GA 30317

Mailing address

2064 Ridgedale Rd NE
Atlanta, GA 30317-1240
Phone (888) 719-5445

Other identifiers 1

IdentifierTypeStateIssuer
LPN059388OtherGANURSING LICENSE

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPN059388GAMDReligious Nonmedical Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Third Day Ministry Religious Nonmedical Practitioner Past Accepting new patients

Organizations & group practices 1

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": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357689600000",
    "number": "1891032157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2064 RIDGEDALE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303171240",
            "telephone_number": "888-719-5445",
            "fax_number": "678-805-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2064 RIDGEDALE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30317",
            "telephone_number": "888-719-5445",
            "fax_number": "678-805-4743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "CARLA",
        "middle_name": "BERNITA",
        "name_prefix": "Dr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN059388",
            "primary": true
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "GA",
            "license": "LPN059388",
            "primary": false
        },
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": "GA",
            "license": "LPN059388",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "LPN059388",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.