Active NPI
Diana C Jones, PA
- Surgical Physician Assistant
- Fort Meade, SD
National Provider Identifier
1093188617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 1033
- Practice address
- 113 Comanche Rd
Fort Meade, SD 57741-1002 - Phone
- (605) 347-2511
- NPI assigned
- Nov 4, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 1033 | SD | Primary |
Addresses
Primary practice location
113 Comanche Rd
Fort Meade, SD 57741-1002
Mailing address
113 Comanche Rd
Fort Meade, SD 57741-1002
Phone (605) 347-2511
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1033 | SD | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733616000000",
"number": "1093188617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 COMANCHE RD",
"city": "FORT MEADE",
"state": "SD",
"postal_code": "577411002",
"telephone_number": "605-347-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 COMANCHE RD",
"city": "FORT MEADE",
"state": "SD",
"postal_code": "577411002",
"telephone_number": "605-347-2511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "DIANA",
"middle_name": "C",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-04",
"last_updated": "2024-12-08",
"certification_date": "2024-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "SD",
"license": "1033",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Meade, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.