Individual provider Active NPI

Jon William Mares, D.O.

  • Nephrology Physician
  • Covington, LA
National Provider Identifier
1023375300
Registry record updated Sep 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
036.151545 Issued in IL
Practice address
1970 N Highway 190
Covington, LA 70433-5364
Phone
(985) 867-8585
Fax
(985) 867-3644
NPI assigned
Apr 11, 2012
Last updated
Sep 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Q6769 TX
Nephrology Physician 207RN0300X 036.151545 IL Primary

Addresses

Primary practice location

1970 N Highway 190
Covington, LA 70433-5364

Mailing address

PO Box 3370
Covington, LA 70434-3370
Phone (985) 867-8585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210713001349 LA Practitioner - Nephrology 9234440736 Reassigns benefits to 2 organizations
I20260319001503 MS Practitioner - Nephrology 9234440736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Kansas City University of Physicians and Surgeons, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nni Covington LLCGroup PAC ID 7517209364, 6 clinicians

Practice addresses (Care Compare)

1970 N Hwy 190
Covington, LA 70433-5364
Phone (985) 867-8585

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
036.151545ILMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Mississippi Nephrology, PLLC Nephrology CurrentSince Mar 4, 2026 Accepting new patients
JWM Renal, LLC Nephrology CurrentSince Aug 19, 2025 Accepting new patients
Nni Covington LLC Nephrology CurrentSince Jun 29, 2025 Accepting new patients
Waccamaw Kidney & Hypertension Specialists,P.a. Nephrology CurrentSince Jul 1, 2019 Accepting new patients
Cardiovascular Care Providers, Inc. PastSince Apr 21, 2020 Accepting new patients

Locations

1415 Avenue F
Bogalusa, LA 70427
Phone (985) 735-1198

1970 N Highway 190
Covington, LA 70433
Phone (985) 400-5988

4300B W Railroad St
Gulfport, MS 39501
Phone (228) 863-5705

1052A Huger Dr
Georgetown, SC 29440
Phone (843) 546-0223

827 Church St
Georgetown, SC 29440
Phone (843) 546-0223

Interoperability endpoints

  • Direct secure messaging: jmares32711@direct.acumenmd.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758067200000",
    "number": "1023375300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3370",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704343370",
            "telephone_number": "985-867-8585",
            "fax_number": "985-867-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 N HIGHWAY 190",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704335364",
            "telephone_number": "985-867-8585",
            "fax_number": "985-867-3644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARES",
        "first_name": "JON",
        "middle_name": "WILLIAM",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2025-09-17",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "Q6769",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "IL",
            "license": "036.151545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.