Active NPI
Jennifer D Stone, M.D.
- Family Medicine Physician
- Council Bluffs, IA
National Provider Identifier
1003058280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34707
- Practice address
- 1 Edmundson PL
Suite 310
Council Bluffs, IA 51503-4658 - Phone
- (712) 396-4280
- Fax
- (712) 396-4180
- NPI assigned
- Apr 2, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34707 | IA | Primary |
Addresses
Primary practice location
1 Edmundson PL
Suite 310
Council Bluffs, IA 51503-4658
Mailing address
PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003058280 | Medicaid | IA | |
| 470687317-12 | Medicaid | NE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34707 | IA | MD | Family Medicine Physician |
Interoperability endpoints
- jennifer.stone@direct.nmhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1396569600000",
"number": "1003058280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3755",
"city": "OMAHA",
"state": "NE",
"postal_code": "681030755",
"telephone_number": "402-354-2100",
"fax_number": "402-354-2155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 EDMUNDSON PL",
"address_2": "SUITE 310",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515034658",
"telephone_number": "712-396-4280",
"fax_number": "712-396-4180"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STONE",
"first_name": "JENNIFER",
"middle_name": "D",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-02",
"last_updated": "2014-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "34707",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1003058280",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470687317-12",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.