Active NPI
Charles Earl Jones, M.D.
- Ophthalmology Physician
- Sioux City, IA
National Provider Identifier
1295739977
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 17131
- 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, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7790418 | Medicaid | SD | |
| 1903542 | Medicaid | IA | |
| 236397600 | Medicaid | MN | |
| 10025032100 | Medicaid | NE | |
| 7071076 | Medicaid | IA | |
| 7790412 | Medicaid | SD | |
| 7790419 | Medicaid | SD | |
| 46044447400 | Medicaid | NE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17131 | IA | MD | Addiction (Substance Use Disorder) Counselor |
| 3309 | SD | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CJ Elmwood Partners L P | Past | 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.
-
- Ambulatory Surgical Clinic/Center
- Sioux City, IA
- NPI 1780661967
-
- Ambulatory Surgical Clinic/Center
- Sioux Falls, SD
- NPI 1093792244
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.