Individual provider Active NPI

Mallory Rawson Jones

  • Physician Assistant
  • Rincon, GA
National Provider Identifier
1891229027
Registry record updated Apr 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5629 Hwy 21 S
Rincon, GA 31326-9416
Phone
(912) 295-2133
NPI assigned
Apr 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5629 Hwy 21 S
Rincon, GA 31326-9416

Mailing address

5629 Hwy 21 S
Rincon, GA 31326-9416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170711000238 GA Practitioner - Physician Assistant 9537438395 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008368GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pediatric Specialists LLC Past Accepting new patients

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": "1492128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1891229027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5629 HWY 21 S",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313269416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5629 HWY 21 S",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313269416",
            "telephone_number": "912-295-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MALLORY",
        "middle_name": "RAWSON",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-14",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

Verify at the official NPI Registry.