Active NPI
Walter Ellis Jones III
- Counselor
- Cumming, GA
National Provider Identifier
1992248173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC009174
- Practice address
- 107 Colony Park Dr
Suite 700
Cumming, GA 30040-2787 - Phone
- (470) 505-3576
- NPI assigned
- Nov 21, 2016
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC009174 | GA | Primary |
Addresses
Primary practice location
107 Colony Park Dr
Suite 700
Cumming, GA 30040-2787
Mailing address
107 Colony Park Dr
Suite 700
Cumming, GA 30040-2787
Phone (470) 505-3576
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479686400000",
"number": "1992248173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 COLONY PARK DR",
"address_2": "SUITE 700",
"city": "CUMMING",
"state": "GA",
"postal_code": "300402787",
"telephone_number": "470-505-3576"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 COLONY PARK DR",
"address_2": "SUITE 700",
"city": "CUMMING",
"state": "GA",
"postal_code": "300402787",
"telephone_number": "470-505-3576"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "WALTER",
"middle_name": "ELLIS",
"name_prefix": "Mr.",
"name_suffix": "III",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-21",
"last_updated": "2016-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "LPC009174",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cumming, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.