Active NPI
Jerome T Jones
- Home Modifications Contractor
- Saint Cloud, MN
National Provider Identifier
1336323757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- Practice address
- 1461 25TH St SE
Saint Cloud, MN 56304-9500 - Phone
- (320) 282-1809
- Fax
- (320) 230-2042
- NPI assigned
- Dec 20, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | MN | Primary |
Addresses
Primary practice location
1461 25TH St SE
Saint Cloud, MN 56304-9500
Mailing address
1461 25TH St SE
Saint Cloud, MN 56304-9500
Phone (320) 282-1809
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20-1161512 | MN | MD | Home Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198108800000",
"number": "1336323757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1461 25TH ST SE",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563049500",
"telephone_number": "320-282-1809",
"fax_number": "320-230-2042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1461 25TH ST SE",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563049500",
"telephone_number": "320-282-1809",
"fax_number": "320-230-2042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "JEROME",
"middle_name": "T",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-20",
"last_updated": "2007-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "MN",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.