Individual provider Active NPI

Mark S Jones, O.D.

  • Optometrist
  • Panama City, FL
National Provider Identifier
1003831165
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OP 2281 Issued in FL
Practice address
2500 Martin Luther King Jr Blvd
Panama City, FL 32405-4412
Phone
(850) 784-3937
Fax
(850) 522-9829
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OP 2281 FL Primary
Corneal and Contact Management Optometrist 152WC0802X OP 2281 FL

Addresses

Primary practice location

2500 Martin Luther King Jr Blvd
Panama City, FL 32405-4412

Mailing address

2500 Martin Luther King Jr Blvd
Panama City, FL 32405-4412
Phone (850) 784-3937

Other identifiers 3

IdentifierTypeStateIssuer
084167600MedicaidFL
410042389OtherFLRR MEDICARE
19054OtherFLBLUE CROSS & BLUE SHIELD

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

State licenses

LicenseStateTypeSpecialty
OP 2281FLMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223510400000",
    "number": "1003831165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MARTIN LUTHER KING JR BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054412",
            "telephone_number": "850-784-3937",
            "fax_number": "850-522-9829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MARTIN LUTHER KING JR BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054412",
            "telephone_number": "850-784-3937",
            "fax_number": "850-522-9829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MARK",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2008-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OP 2281",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OP 2281",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "084167600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "410042389",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "19054",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.