Provider Demographics
NPI:1003688086
Name:JONES, REMINGTON KYLE (PA)
Entity type:Individual
Prefix:
First Name:REMINGTON
Middle Name:KYLE
Last Name:JONES
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6740 MALLARD LAKE CT
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-6929
Mailing Address - Country:US
Mailing Address - Phone:540-676-4702
Mailing Address - Fax:
Practice Address - Street 1:3101 BEAUMONT CENTRE CIR STE 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1959
Practice Address - Country:US
Practice Address - Phone:859-323-5544
Practice Address - Fax:859-257-9286
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA3551363AM0700X, 363AS0400X, 363A00000X
KYTC067363A00000X
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