Provider Demographics
NPI:1144295593
Name:JONES, TAMARA ALETTA (MD)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:ALETTA
Last Name:JONES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:920 CHURCH ST N
Practice Address - Street 2:SUITE 255
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-2927
Practice Address - Country:US
Practice Address - Phone:704-403-1331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-02461208M00000X, 207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI40659Medicare UPIN
VA10036449OtherSHP/OHP
VA1100456OtherUSA MANAGED CARE (EVMS HEALTH SERVICES)
VA351506OtherANTHEM EVMS HEALTH SERVICES
VAPAROtherFIRST HEALTH COMMERCIAL
VAI40659Medicare UPIN
VAPAROtherVA HEALTH NETWORK (EVMS HEALTH SERVICES)
VA2180423OtherUHC/MAMSI (EVMS HEALTH SERVICES)
VAMC10791Medicare PIN
VAPAROtherCORVEL/CORCARE (EVMS HEALTH SERVICES)
VAPAROtherMULTIPLAN
VA1144295593Medicaid
VA-028OtherTRICARE (EVMS HEALTH SERVICES)
NC5909654Medicaid
VA0182130OtherCIGNA (EVMS HEALTH SERVICES)
VA7225722OtherAETNA (EVMS HEALTH SERVICES)
VAPAROtherVA PREMIER HEALTH
VAP00697170Medicare PIN