Active NPI
Susan Jean Jones, LPN
- Licensed Practical Nurse
- Rock Creek, OH
National Provider Identifier
1033290176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN109138
- Practice address
- 5131 Boughner Rd
Rock Creek, OH 44084-9756 - Phone
- (440) 474-5973
- NPI assigned
- Oct 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN109138 | OH | Primary |
Addresses
Primary practice location
5131 Boughner Rd
Rock Creek, OH 44084-9756
Mailing address
3535 State Route 193
Kingsville, OH 44048-9725
Phone (440) 224-3085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2284362 | Other | OH | INDEPENDENT PROVIDER# |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN109138 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1033290176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3535 STATE ROUTE 193",
"city": "KINGSVILLE",
"state": "OH",
"postal_code": "440489725",
"telephone_number": "440-224-3085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5131 BOUGHNER RD",
"city": "ROCK CREEK",
"state": "OH",
"postal_code": "440849756",
"telephone_number": "440-474-5973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "SUSAN",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN109138",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT PROVIDER#",
"identifier": "2284362",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rock Creek, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.