Provider Demographics
NPI:1245219666
Name:JONES, SCOTT JASON (PA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:JASON
Last Name:JONES
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 SEVEN SPRINGS WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4576
Mailing Address - Country:US
Mailing Address - Phone:615-370-9992
Mailing Address - Fax:615-370-9665
Practice Address - Street 1:1114 N MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37160-2380
Practice Address - Country:US
Practice Address - Phone:615-370-9992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA1154363AM0700X
TN1154363AS0400X
TNPA0000001154363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1533351Medicaid
TN10397I7157Medicare PIN
TNP88917Medicare UPIN
FLU0635YMedicare UPIN
TNP88917Medicare UPIN