Basic Information
Provider Information
NPI: 1841952314
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JONES
FirstName: ALEXIS
MiddleName: LE'KRIS
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2424 DOUBLE CHURCHES RD
Address2:  
City: COLUMBUS
State: GA
PostalCode: 319092741
CountryCode: US
TelephoneNumber: 7063246112
FaxNumber: 7065968259
Practice Location
Address1: 2424 DOUBLE CHURCHES RD
Address2:  
City: COLUMBUS
State: GA
PostalCode: 319092741
CountryCode: US
TelephoneNumber: 7063246112
FaxNumber: 7065968259
Other Information
ProviderEnumerationDate: 10/12/2021
LastUpdateDate: 10/12/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/12/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT008232GAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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