1992806624 NPI number — J KIPLING JONES MD LTD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992806624 NPI number — J KIPLING JONES MD LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
J KIPLING JONES MD LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992806624
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHESTERFIELD
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23832-6691
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-751-0453
Provider Business Mailing Address Fax Number:
804-796-1997

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9844 LORI ROAD
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
CHESTERFIELD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23832-6691
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-751-0453
Provider Business Practice Location Address Fax Number:
804-796-1997
Provider Enumeration Date:
09/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
KIPLING
Authorized Official Title or Position:
PHYSICIAN OWNER CHAIRMAN OF THE BOA
Authorized Official Telephone Number:
804-751-0453

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  VA0101034460 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2084P0804X , with the licence number: VA0101034460 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00711934B , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 70475 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4398155 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1563099 . This is a "UNITED BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 215958 . This is a "COMPSYCH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 333804 . This is a "MENTAL HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000258 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 461621 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".




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