Individual provider Active NPI

Suzanne M Jones, FNP

  • Nurse Practitioner
  • Prineville, OR
National Provider Identifier
1063824423
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1733 Issued in HI
Practice address
375 NW Beaver St Ste 101
Prineville, OR 97754-1802
Phone
(541) 447-0707
Fax
(541) 383-1883
NPI assigned
May 20, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1733 HI Primary
Family Nurse Practitioner 363LF0000X 201700943NP-PP OR

Addresses

Primary practice location

375 NW Beaver St Ste 101
Prineville, OR 97754-1802

Mailing address

75-5751 Kuakini Hwy
Ste 203
Kailua Kona, HI 96740-1753
Phone (808) 326-5629

Other practice location 1

1250 SW Veterans Way Ste 120
Redmond, OR 97756-2585
Phone (541) 923-4462

Other identifiers 1

IdentifierTypeStateIssuer
500720837MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200910001959 HI Practitioner - Nurse Practitioner 8729362769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

75-5751 Kuakini Hwy
Kailua Kona, HI 96740-1705
Phone (808) 326-5629

75-5751 Kuakini Hwy 203
Kailua Kona, HI 96740-1752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1733HIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Hawaii Community Health Center, Inc. CurrentSince Aug 3, 2020 Accepting new patients
West Hawaii Community Health Center, Inc. CurrentSince Aug 3, 2020 Accepting new patients

Locations

450 Kilauea Ave
Ste 101105
Hilo, HI 96720

73 Puuhonu Pl
Ste 204
Hilo, HI 96720
Phone (808) 333-3500

1178 Kinoole St
Hilo, HI 96720
Phone (808) 961-4082

305 Wailuku Dr
Ste 2A
Hilo, HI 96720
Phone (808) 933-2982

75-5751 Kuakini Hwy
Ste 203
Kailua Kona, HI 96740
Phone (808) 326-3878

75-5751 Kuakini Hwy
Ste 101A
Kailua Kona, HI 96740

75-5751 Kuakini Hwy
Ste 101A
Kailua Kona, HI 96740

16-192 Pili Mua St
Keaau, HI 96749
Phone (808) 930-0040

81-980 Halekii St
Ste 107
Kealakekua, HI 96750
Phone (808) 324-0703

81-6627 Mamalahoa Hwy
Ste 106
Kealakekua, HI 96750
Phone (808) 322-8005

15-2866 Pahoa Village Rd
Bldg F
Pahoa, HI 96778
Phone (808) 825-8275

15-2866 Pahoa Village Rd
Bldg C
Pahoa, HI 96778
Phone (808) 965-9711

Networks

  • HI PPO

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1063824423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-5751 KUAKINI HWY",
            "address_2": "STE 203",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401753",
            "telephone_number": "808-326-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 NW BEAVER ST STE 101",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977541802",
            "telephone_number": "541-447-0707",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 SW Veterans Way Ste 120",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "OR",
            "postal_code": "977562585",
            "country_code": "US",
            "telephone_number": "541-923-4462",
            "fax_number": "541-383-1883",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "SUZANNE",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-20",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "HI",
            "license": "1733",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201700943NP-PP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500720837",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prineville, OR

Sources for this page

Verify at the official NPI Registry.