Individual provider Active NPI

Clifford Jones, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wichita, KS
National Provider Identifier
1154408169
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
74633 Issued in KS
Practice address
8911 E Orme St
Suite a
Wichita, KS 67207-2423
Phone
(316) 686-7884
Fax
(316) 686-0036
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 13-41899-092 KS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 74633 KS Primary

Addresses

Primary practice location

8911 E Orme St
Suite a
Wichita, KS 67207-2423

Mailing address

8911 E Orme St
Suite a
Wichita, KS 67207-2423
Phone (316) 686-7884

Other identifiers 1

IdentifierTypeStateIssuer
100457120BMedicaidKS

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
13-41899-092KSMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1154408169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8911 E ORME ST",
            "address_2": "SUITE A",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672072423",
            "telephone_number": "316-686-7884",
            "fax_number": "316-686-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8911 E ORME ST",
            "address_2": "SUITE A",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672072423",
            "telephone_number": "316-686-7884",
            "fax_number": "316-686-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "CLIFFORD",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "KS",
            "license": "13-41899-092",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KS",
            "license": "74633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100457120B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; 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.