Individual provider Active NPI

Dean Edward Jones

  • Family Nurse Practitioner
  • Bloomington, IN
National Provider Identifier
1114220761
Registry record updated Jun 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71003585A Issued in IN
Practice address
514 W 2ND St
Bloomington, IN 47403-2316
Phone
(812) 353-3716
Fax
(812) 353-9630
NPI assigned
Dec 20, 2010
Last updated
Jun 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71003585A IN Primary

Addresses

Primary practice location

514 W 2ND St
Bloomington, IN 47403-2316

Mailing address

PO Box 1329
Bloomington, IN 47402-1329

Other identifiers 1

IdentifierTypeStateIssuer
201062950MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20110825000005 IN Practitioner - Nurse Practitioner 0547430803 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paradigm Living Concepts LLCGroup PAC ID 1355575424, 13 clinicians

Practice addresses (Care Compare)

8904 Bash St
Suite B
Indianapolis, IN 46256-1286
Phone (317) 735-6001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paradigm Living Concepts, LLC CurrentSince Jan 26, 2026 Accepting new patients
Paradigm Living Concepts, LLC CurrentSince Jan 26, 2026 Accepting new patients
Iu Health Medical Group, LLC Family Past Accepting new patients

Locations

8904 Bash St
Ste B
Indianapolis, IN 46256
Phone (317) 735-6001

Organizations & group practices 4

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": "1292803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592524800000",
    "number": "1114220761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1329",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474021329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 W 2ND ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032316",
            "telephone_number": "812-353-3716",
            "fax_number": "812-353-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "DEAN",
        "middle_name": "EDWARD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-20",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003585A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201062950",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.