Provider Demographics
NPI:1104093186
Name:JONES ADAPTIVE MOBILITY LLC
Entity type:Organization
Organization Name:JONES ADAPTIVE MOBILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:423-844-0939
Mailing Address - Street 1:3441 HIGHWAY 126
Mailing Address - Street 2:
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-4525
Mailing Address - Country:US
Mailing Address - Phone:423-844-0939
Mailing Address - Fax:615-514-9654
Practice Address - Street 1:3441 HIGHWAY 126
Practice Address - Street 2:
Practice Address - City:BLOUNTVILLE
Practice Address - State:TN
Practice Address - Zip Code:37617-4525
Practice Address - Country:US
Practice Address - Phone:423-844-0939
Practice Address - Fax:423-484-0368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TN65771332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6140950001Medicare NSC