Jada Chantel Jones, PHLEBOTOMIST

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

License

20-0351Y16 Issued in CT

Practice address

21 Cooke St Unit 2B
Waterbury, CT 06710-2302

Phone

(475) 323-3059

NPI assigned

Jun 26, 2019

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 26, 2019.

{
    "created_epoch": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1164083598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 COOKE ST UNIT 2B",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067102302",
            "telephone_number": "475-323-3059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 COOKE ST UNIT 2B",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067102302",
            "telephone_number": "475-323-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "JADA",
        "middle_name": "CHANTEL",
        "credential": "PHLEBOTOMIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "CT",
            "license": "20-0351Y16",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Vampireonthegoct@gmail.com",
            "affiliation": "N",
            "address_1": "21 Cooke St Unit 2B",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067102302",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Vampireonthegoct@gmail.com",
            "affiliation": "N",
            "address_1": "21 Cooke St Unit 2B",
            "city": "Waterbury",
            "state": "CT",
            "country_code": "US",
            "postal_code": "067102302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Waterbury, CT
• Phlebotomy Technician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; 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.