Individual provider Active NPI

Charles Earl Jones, M.D.

  • Ophthalmology Physician
  • Sioux City, IA
National Provider Identifier
1295739977
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
17131 Issued in IA
Practice address
4405 Hamilton Blvd
Sioux City, IA 51104-1140
Phone
(712) 239-3937
Fax
(712) 239-4946
NPI assigned
Jun 9, 2005
Last updated
Apr 7, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 17131 IA Primary
Ophthalmology Physician 207W00000X 3309 SD

Addresses

Primary practice location

4405 Hamilton Blvd
Sioux City, IA 51104-1140

Mailing address

4405 Hamilton Blvd
Sioux City, IA 51104-1140
Phone (712) 239-3937

Other identifiers 8

IdentifierTypeStateIssuer
7790418MedicaidSD
1903542MedicaidIA
236397600MedicaidMN
10025032100MedicaidNE
7071076MedicaidIA
7790412MedicaidSD
7790419MedicaidSD
46044447400MedicaidNE

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17131IAMDAddiction (Substance Use Disorder) Counselor
3309SDMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CJ Elmwood Partners L P PastSince Oct 1, 1996 Accepting new patients

Organizations & group practices 2

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1295739977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 HAMILTON BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511041140",
            "telephone_number": "712-239-3937",
            "fax_number": "712-239-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 HAMILTON BLVD",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511041140",
            "telephone_number": "712-239-3937",
            "fax_number": "712-239-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "CHARLES",
        "middle_name": "EARL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "17131",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SD",
            "license": "3309",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7790418",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1903542",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "236397600",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025032100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7071076",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7790412",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7790419",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46044447400",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; 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.