Organization Active NPI

Edward Lawrence Jones & Assoc

  • Optometrist
  • Kent, WA
National Provider Identifier
1144353228
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1651 Issued in WA
Legal business name
EDWARD LAWRENCE JONES & ASSOC
Practice address
601 W Gowe St
Kent, WA 98032-5745
Phone
(253) 854-2028
Fax
(253) 854-2744
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Authorized official

Name
Mrs. Maxine Jones
Title
V.P. Administration
Phone
(206) 941-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1651 WA Primary

Addresses

Primary practice location

601 W Gowe St
Kent, WA 98032-5745

Mailing address

13530 SE 181St PL
Renton, WA 98058-6806
Phone (206) 941-2000

Other identifiers 2

IdentifierTypeStateIssuer
2030187MedicaidWA
G8880384OtherWAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090421000628 WA Part B Supplier - Clinic/Group Practice 4486546868 Receives reassigned benefits from 1 practitioner
Practice locations: Kent, WA

National Provider Directory

National Provider Directory

Locations

620 SE Everett Mall Way
Ste 320
Everett, WA 98208
Phone (425) 355-2377

601 W Gowe St
Kent, WA 98032
Phone (253) 854-2028

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1144353228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13530 SE 181ST PL",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980586806",
            "telephone_number": "206-941-2000",
            "fax_number": "425-235-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W GOWE ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980325745",
            "telephone_number": "253-854-2028",
            "fax_number": "253-854-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD LAWRENCE JONES & ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MAXINE",
        "authorized_official_title_or_position": "V.P. ADMINISTRATION",
        "authorized_official_telephone_number": "206-941-2000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2030187",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8880384",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.