Individual provider Active NPI

Jada Chantel Jones, PHLEBOTOMIST

  • Phlebotomy Technician
  • Waterbury, CT
National Provider Identifier
1164083598
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
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
Last updated
Jun 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X 20-0351Y16 CT Primary

Addresses

Primary practice location

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

Mailing address

21 Cooke St Unit 2B
Waterbury, CT 06710-2302
Phone (475) 323-3059

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL Vampireonthegoct@gmail.com
Other URL Vampireonthegoct@gmail.com

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

State licenses

LicenseStateTypeSpecialty
20-0351Y16CTMDPhlebotomy Technician

NPI Registry JSON

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

{
    "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": []
}

Other providers in Waterbury, CT

Sources for this page

  • 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.