Individual provider Active NPI

Douglas Carroll Jones

  • Addiction (Substance Use Disorder) Counselor
  • Minneapolis, MN
National Provider Identifier
1073800769
Registry record updated Jul 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
302811 Issued in MN
Practice address
1911 Pleasant Ave
Minneapolis, MN 55403-3506
Phone
(612) 874-9811
Fax
(612) 874-9820
NPI assigned
Jul 1, 2011
Last updated
Jul 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 302811 MN Primary

Addresses

Primary practice location

1911 Pleasant Ave
Minneapolis, MN 55403-3506

Mailing address

1911 Pleasant Ave
Minneapolis, MN 55403-3506
Phone (612) 874-9811

Other identifiers 1

IdentifierTypeStateIssuer
302811OtherMNALCOHOL AND DRUG ABUSE COUNSELOR

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

LicenseStateTypeSpecialty
302811MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Resources for Education Alternative Treatments & Evaluation Addiction (Substance Use Disorder) Past Accepting new patients
Create Inc Addiction (Substance Use Disorder) Past Accepting new patients

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309478400000",
    "number": "1073800769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 PLEASANT AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033506",
            "telephone_number": "612-874-9811",
            "fax_number": "612-874-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 PLEASANT AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033506",
            "telephone_number": "612-874-9811",
            "fax_number": "612-874-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "DOUGLAS",
        "middle_name": "CARROLL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2011-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "302811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALCOHOL AND DRUG ABUSE COUNSELOR",
            "identifier": "302811",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; 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.