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TONY JONES M.D.
NPI 1770648347
Family Medicine in Cherokee, NC

Active since December 26, 2006PECOS EnrolledAccepts Medicare Assignment
1 HOSPITAL RD, CHEROKEE, NC 28719(828) 497-9163 Get Directions Write a Review

NPPES record last updated: January 25, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Tony Jones M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TONY JONES M.D. (NPI 1770648347) is an individual family medicine provider in Cherokee, North Carolina, licensed in North Carolina (200401405) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Cherokee Indian Hospital Authority, and is a graduate of University Of North Carolina At Chapel Hill School Of Medicine (1990).

NPPES Registry Identity

NPI1770648347
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameTONY JONESCredential: M.D.
Location Address1 HOSPITAL RDCherokee, NC 28719-2871
Mailing Address119 Park StCanton, NC 28716-4319 · (828) 235-3023 · Fax (828) 452-8837
Phone(828) 497-9163
Sole ProprietorNo
Medical School CMSUniversity Of North Carolina At Chapel Hill School Of MedicineGraduated 1990
Enumeration DateDecember 26, 2006
Last NPPES UpdateJanuary 25, 2023
NPPES CertifiedJanuary 18, 2023
✔ NPI 1770648347 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 200401405
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1 HOSPITAL RD, Cherokee, NC 28719
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter Health, Ambetter of North Carolina and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tony Jones M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID749247807
PECOS Enrollment IDI20201208000471
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Tony Jones reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Cherokee Indian Hospital Authority
Same address
Ambulatory Surgical
1 HOSPITAL ROAD, CALLER BOX C-268
Cherokee, NC 28719
  • Reassigned Medicare billing, Texas enrollment
  • 161 clinicians in this Medicare group
NPI 1396119616 (828) 497-9163
Dlp Western Carolina Physician Practices LLC
9.4 mi
Rural Health
98 DOCTORS DR STE 300
Sylva, NC 28779
  • Reassigned Medicare billing, North Carolina enrollment
  • 456 clinicians in this Medicare group
NPI 1316718497 (828) 586-9642

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
88 services62 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
84 services60 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
51 services42 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
37 services34 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
30 services28 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
26 services23 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cherokee Indian Hospital Authority

Acute Care Hospitals · Cherokee, NC
OwnershipGovernment - Federal
CMS Certification Number340156
LocationCaller Box C268Cherokee, NC 28719 · Swain County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28719 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
56%316 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
64%828 patients4/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
39%231 patients2/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
96%9,800 patients4/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
48%321 patients2/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
61%556 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
97%216 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
92%1,558 patients4/55-star benchmark: 97%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
31%321 patients2/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
37%1,463 patients2/55-star benchmark: 97%
Preventive Care and Screening: Influenza Immunization
Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization
19%961 patients1/55-star benchmark: 88%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
44%1,047 patients2/55-star benchmark: 96%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 98% · 975 patients
Patients tobacco: 23% · 100 patients
79%975 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%1,558 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
20%1,558 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
19%1,558 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each E0483
DME-Other DME · category DE000N
1 supplier12 claims12 services$814.01 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier11 claims11 services$8.71 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
4 suppliers58 claims58 services$186.89 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEY KEEL
Peer Specialist
1 HOSPITAL RD, CALLER BOX C-268
CHEROKEE, NC 28719
Swain County (828) 497-9163
JUSTICE LEE LITTLEJOHN PSS
Peer Specialist
1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163
KYLEE SAVAGE
Physician Assistant
1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163
MRS. KELLIE LEIGH BROWN MSW, LCSW-A
Social Worker (Clinical)
1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163
AMANDA HARRIS LEDFORD
Physical Therapy Assistant
1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163
EMILY R MEEKS RD
Dietitian, Registered
1 HOSPITAL RD, 1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163
ELIZABETH COLEMAN MCDONALD FNP-C
Nurse Practitioner (Family)
1 HOSPITAL RD, CALLER BOX C-268
CHEROKEE, NC 28719
Swain County (828) 497-9163
SHELBY CANNON HEATH M.S., CCC-SLP
Speech-Language Pathologist
1 HOSPITAL RD
CHEROKEE, NC 28719
Swain County (828) 497-9163

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tony Jones's NPI number?

The NPI number for Tony Jones is 1770648347. It was assigned to this individual provider in the NPPES registry on December 26, 2006.

Where is Tony Jones located?

Tony Jones practices at 1 Hospital Rd, Cherokee, NC 28719. The listed phone number is (828) 497-9163.

What is Tony Jones's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Tony Jones enrolled in Medicare?

Yes. Tony Jones is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Tony Jones's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tony Jones reassigns Medicare benefits to 2 organizations: Cherokee Indian Hospital Authority (Cherokee, NC) and Dlp Western Carolina Physician Practices LLC (Sylva, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tony Jones's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tony Jones accept?

Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and AmeriHealth Caritas Next list Tony Jones as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Tony Jones affiliated with any hospitals?

According to CMS data, Tony Jones is affiliated with Cherokee Indian Hospital Authority.

When was this NPI record last updated?

The NPPES record for Tony Jones was last updated on January 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.