Individual provider Active NPI

Laurence Roosevelt Jones

  • Clinical Social Worker
  • Buffalo, NY
National Provider Identifier
1306230982
Registry record updated Apr 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0887337 Issued in NY
Practice address
112 Lonsdale Rd
Buffalo, NY 14208-1532
Phone
(716) 520-7547
Fax
(716) 235-8250
NPI assigned
Mar 23, 2015
Last updated
Apr 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 093926 NY
Clinical Social Worker 1041C0700X 0887337 NY Primary
Licensed Practical Nurse 164W00000X 275234-1 NY

Addresses

Primary practice location

112 Lonsdale Rd
Buffalo, NY 14208-1532

Mailing address

112 Lonsdale Rd
Buffalo, NY 14208-1532
Phone (716) 520-7547

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181116000595 NY Practitioner - Clinical Social Worker 6507110236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0887337NYMDClinical Social Worker
093926NYMDClinical Social Worker
275234-1NYMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Erie 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.

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649462400000",
    "number": "1306230982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LONSDALE RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142081532",
            "telephone_number": "716-520-7547",
            "fax_number": "716-235-8250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LONSDALE RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142081532",
            "telephone_number": "716-520-7547",
            "fax_number": "716-235-8250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "LAURENCE",
        "middle_name": "ROOSEVELT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-23",
        "last_updated": "2022-04-09",
        "certification_date": "2022-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "093926",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0887337",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "275234-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

Verify at the official NPI Registry.