Individual provider Active NPI

Sandra Jean Jones, FNP-BC

  • Family Nurse Practitioner
  • Florence, OR
National Provider Identifier
1043203581
Registry record updated Aug 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
603779 Issued in TX
Practice address
380 9TH St
Florence, OR 97439-9470
Phone
(541) 997-7134
Fax
(541) 902-1601
NPI assigned
Aug 30, 2005
Last updated
Aug 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 603779 TX Primary
Family Nurse Practitioner 363LF0000X 201500551NP-PP OR

Addresses

Primary practice location

380 9TH St
Florence, OR 97439-9470

Mailing address

1115 SE 164TH Ave Dept 358
Vancouver, WA 98683-8004
Phone (855) 333-6947

Other identifiers 1

IdentifierTypeStateIssuer
500681732MedicaidOR

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
201500551NP-PPORMDFamily Nurse Practitioner
603779TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth PastSince Aug 22, 2016 Accepting new patients
Jon S. Tompkins, D.O. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sjones70985@direct.peacehealth.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471651200000",
    "number": "1043203581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986838004",
            "telephone_number": "855-333-6947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 9TH ST",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974399470",
            "telephone_number": "541-997-7134",
            "fax_number": "541-902-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SANDRA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2016-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "603779",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201500551NP-PP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500681732",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2016; 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.