Individual provider Active NPI

Jennie Blakeley Jones

  • Pediatric Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1255655692
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP118774 Issued in TX
Practice address
1935 Medical District Dr
Dallas, TX 75235-7701
Phone
(214) 456-7000
NPI assigned
Mar 14, 2010
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 701133 TX
Pediatric Nurse Practitioner 363LP0200X AP118774 TX Primary

Addresses

Primary practice location

1935 Medical District Dr
Dallas, TX 75235-7701

Mailing address

1935 Medical District Dr
Dallas, TX 75235-7701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190311000040 TX Practitioner - Nurse Practitioner 0244579233 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 1, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 1, 2021 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

7601 Preston Rd
Ste P3600
Plano, TX 75024
Phone (469) 303-3000

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1268524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1255655692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 MEDICAL DISTRICT DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752357701",
            "telephone_number": "214-456-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "JENNIE",
        "middle_name": "BLAKELEY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-14",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "701133",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP118774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.