Active NPI
Kenneth L Jones, PA-C
- Medical Physician Assistant
- Vernon, FL
National Provider Identifier
1992057046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9103547
- Practice address
- 3591 Twin Pond Rd
Vernon, FL 32462-3362 - Phone
- (850) 625-6271
- NPI assigned
- Oct 12, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9103547 | FL | Primary |
Addresses
Primary practice location
3591 Twin Pond Rd
Vernon, FL 32462-3362
Mailing address
3591 Twin Pond Rd
Vernon, FL 32462-3362
Phone (850) 625-6271
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
| License | State | Type | Specialty |
|---|---|---|---|
| PA9103547 | FL | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350000000000",
"number": "1992057046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3591 TWIN POND RD",
"city": "VERNON",
"state": "FL",
"postal_code": "324623362",
"telephone_number": "850-625-6271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3591 TWIN POND RD",
"city": "VERNON",
"state": "FL",
"postal_code": "324623362",
"telephone_number": "850-625-6271"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "KENNETH",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-12",
"last_updated": "2012-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9103547",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vernon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.