NPIMap

Individual provider Active NPI

Susan J Jones, M.D.

  • Family Medicine Physician
  • Safford, AZ
National Provider Identifier
1114945201
Registry record updated Aug 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26166 Issued in AZ
Practice address
1680 S 20TH Ave
Safford, AZ 85546-4011
Phone
(928) 428-1377
Fax
(928) 348-8570
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26166 AZ Primary

Addresses

Primary practice location

1680 S 20TH Ave
Safford, AZ 85546-4011

Mailing address

1680 S 20TH Ave
Safford, AZ 85546-4011
Phone (928) 428-1377

Other identifiers 2

IdentifierTypeStateIssuer
238461MedicaidAZ
AZ0251850OtherAZBCBS PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090109000381 AZ Practitioner - Family PracticePractitioner - Emergency Medicine 5991868408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gila Valley Clinic PCGroup PAC ID 4981680683, 13 clinicians

Practice addresses (Care Compare)

1680 S 20TH Ave
Safford, AZ 85546-4011
Phone (928) 428-1377

Hospital & facility affiliations

  • Home Health Safford, LLC Home health agency, Safford, AZ, CCN 037815
  • Mt. Graham Regional Medical Center Hospital, Safford, AZ, CCN 031319
  • Tucson Medical Center Hospital, Tucson, AZ, CCN 030006
  • Haven of Safford Nursing home, Safford, AZ, CCN 035172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Gila Valley Clinic, PC Family Medicine CurrentSince Feb 6, 1998 Accepting new patients
Gila Valley Clinic PC CurrentSince Mar 31, 1997 Accepting new patients
Haven of Safford, LLC Past Accepting new patients

Locations

1680 S 20th Ave
Safford, AZ 85546
Phone (928) 428-1377

1933 W Pepper Tree Dr
Safford, AZ 85546
Phone (928) 428-4910

1600 S 20th Ave
Safford, AZ 85546
Phone (928) 348-4000

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Mt Graham Regional Medical Center IncSafford, AZ, CCN 031319 Hospital Corporate Director Apr 1, 2015
Mt. Graham Regional Medical CenterSafford, AZ, CCN 03Z319 Hospital Corporate Director Apr 1, 2015
Copper Mountain ClinicSafford, AZ, CCN 038503 Rural health clinic Corporate Director Dec 20, 2010
Gila Valley ClinicSafford, AZ, CCN 033839 Rural health clinic 5% Or Greater Direct Ownership Interest (20%)
Corporate Officer
Corporate Director
W-2 Managing Employee		 Jun 1, 1984
Jun 1, 1984
Jun 1, 1984
Jun 1, 1984

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314748800000",
    "number": "1114945201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464011",
            "telephone_number": "928-428-1377",
            "fax_number": "928-348-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 S 20TH AVE",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464011",
            "telephone_number": "928-428-1377",
            "fax_number": "928-348-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SUSAN",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "26166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "238461",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "AZ0251850",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Safford, AZ

Sources for this page

Verify at the official NPI Registry.