Individual provider Active NPI

Ardewa Latae Jones

  • Clinical Medical Laboratory
  • Bartlett, TN
National Provider Identifier
1114770153
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Practice address
6061 Stage Rd Ste 6
Bartlett, TN 38134-8375
Phone
(901) 304-7592
Fax
(901) 234-0258
NPI assigned
Apr 9, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

6061 Stage Rd Ste 6
Bartlett, TN 38134-8375

Mailing address

6061 Stage Rd Ste 6
Bartlett, TN 38134-8375
Phone (901) 304-7592

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

Practice roles

OrganizationSpecialtyStatusNew patients
Swoosh Nemt Service LLC CurrentSince Apr 21, 2024 Accepting new patients

Locations

6061 Stage Rd
Ste 6
Bartlett, TN 38134
Phone (901) 304-7592

Organizations & group practices 1

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": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1114770153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6061 STAGE RD STE 6",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381348375",
            "telephone_number": "901-304-7592",
            "fax_number": "901-234-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6061 STAGE RD STE 6",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381348375",
            "telephone_number": "901-304-7592",
            "fax_number": "901-234-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "ARDEWA",
        "middle_name": "LATAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.

Verify at the official NPI Registry.