Provider Demographics
NPI:1992806624
Name:J KIPLING JONES MD LTD
Entity type:Organization
Organization Name:J KIPLING JONES MD LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER CHAIRMAN OF THE BOA
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:KIPLING
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-751-0453
Mailing Address - Street 1:PO BOX 2200
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-6691
Mailing Address - Country:US
Mailing Address - Phone:804-751-0453
Mailing Address - Fax:804-796-1997
Practice Address - Street 1:9844 LORI ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6691
Practice Address - Country:US
Practice Address - Phone:804-751-0453
Practice Address - Fax:804-796-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA01010344602084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00711934BMedicaid
70475OtherCIGNA
4398155OtherAETNA
1563099OtherUNITED BEHAVIORAL HEALTH
215958OtherCOMPSYCH
333804OtherMENTAL HEALTH NETWORK
000258OtherVALUE OPTIONS
461621OtherANTHEM
70475OtherCIGNA