Organization Active NPI

Jones Pharmacy, LLC

Doing business as Jones Pharmacy

  • Community/Retail Pharmacy
  • Lexington, TN
National Provider Identifier
1891881090
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
269 Issued in TN
Legal business name
JONES PHARMACY, LLC
Doing business as
Jones Pharmacy
Practice address
101 Lexington Plaza
Lexington, TN 38351
Phone
(731) 968-8653
Fax
(731) 967-0939
NPI assigned
Oct 5, 2006
Last updated
Dec 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Authorized official

Name
Samuel D Pace, PHARMD
Title
Owner/Pic
Phone
(731) 614-4259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 269 TN Primary

Addresses

Primary practice location

101 Lexington Plaza
Lexington, TN 38351

Mailing address

101 Lexington Plaza
Lexington, TN 38351
Phone (731) 968-8653

Other identifiers 3

IdentifierTypeStateIssuer
3538067MedicaidTN
4417401OtherNABP
9440432MedicaidTN

Other names 1

  • Jones Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190422001465 TN Part B Supplier - Mass Immunization (Roster Biller Only) 6800146028 Practice locations: Lexington, TN

National Provider Directory

National Provider Directory

Locations

101 Lexington Plz
Lexington, TN 38351
Phone (731) 968-8653

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577059200000",
    "number": "1891881090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LEXINGTON PLAZA",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "38351",
            "telephone_number": "731-968-8653",
            "fax_number": "731-967-0939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LEXINGTON PLAZA",
            "city": "LEXINGTON",
            "state": "TN",
            "postal_code": "38351",
            "telephone_number": "731-968-8653",
            "fax_number": "731-967-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONES PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/PIC",
        "authorized_official_telephone_number": "731-614-4259",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TN",
            "license": "269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3538067",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "4417401",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9440432",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jones Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lexington, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2019; 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.