Individual provider Active NPI

Shari Renee Jones, RN BSN

  • Registered Nurse
  • Mt Vernon, IL
National Provider Identifier
1336240571
Registry record updated Dec 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041291352 Issued in IL
Practice address
4000 South Water Place
Mt Vernon, IL 62864
Phone
(618) 246-2910
Fax
(618) 242-8240
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041291352 IL Primary

Addresses

Primary practice location

4000 South Water Place
Mt Vernon, IL 62864

Mailing address

MTV Cboc
4000 South Water Tower Place
Mt Vernon, IL 62864
Phone (618) 246-2910

Other practice location 1

2401 W Main St
Marion, IL 62959-1188
Phone (618) 246-2910

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shari.jones2@va.gov Health Information Exchange (HIE)

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041291352ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670889600000",
    "number": "1336240571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MTV CBOC",
            "address_2": "4000 SOUTH WATER TOWER PLACE",
            "city": "MT VERNON",
            "state": "IL",
            "postal_code": "62864",
            "telephone_number": "618-246-2910",
            "fax_number": "618-242-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 SOUTH WATER PLACE",
            "city": "MT VERNON",
            "state": "IL",
            "postal_code": "62864",
            "telephone_number": "618-246-2910",
            "fax_number": "618-242-8240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 W Main St",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629591188",
            "country_code": "US",
            "telephone_number": "618-246-2910",
            "fax_number": "618-242-8240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "SHARI",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "RN BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041291352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shari.jones2@va.gov",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2401 W Main St",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629591188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mt Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; 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.