1992806624 NPI number — J KIPLING JONES MD LTD

Table of content: (NPI 1992806624)

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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