Active NPI
Michael C Jones, M.D.
- Urology Physician
- Fredericksburg, TX
National Provider Identifier
1073557930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- F4131
- Practice address
- 703 S Adams St
Fredericksburg, TX 78624-4444 - Phone
- (830) 997-9507
- Fax
- (830) 997-0583
- NPI assigned
- Jun 15, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Urology Physician | 208800000X | F4131 | TX | Primary |
Addresses
Primary practice location
703 S Adams St
Fredericksburg, TX 78624-4444
Mailing address
703 S Adams St
Fredericksburg, TX 78624-4444
Phone (830) 997-9507
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 126479804 | Medicaid | TX | |
| 0616600001 | Other | TX | MEDICARE PALMETTO DME # |
| 340001356 | Other | TX | MEDICARE RAILROAD # |
| 00FP77 | Other | TX | BCBS PROVIDER # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110321001033 | TX | Practitioner - Urology | 0547443053 | Practice locations: Fredericksburg, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490832000000",
"number": "1073557930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 S ADAMS ST",
"city": "FREDERICKSBURG",
"state": "TX",
"postal_code": "786244444",
"telephone_number": "830-997-9507",
"fax_number": "830-997-0583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 S ADAMS ST",
"city": "FREDERICKSBURG",
"state": "TX",
"postal_code": "786244444",
"telephone_number": "830-997-9507",
"fax_number": "830-997-0583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "MICHAEL",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2017-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "TX",
"license": "F4131",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "126479804",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PALMETTO DME #",
"identifier": "0616600001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD #",
"identifier": "340001356",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER #",
"identifier": "00FP77",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fredericksburg, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.