Glyn E. Jones, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

036118115 Issued in IL

Practice address

1001 Main Street
3Rd Floor
Peoria, IL 61606-2037

Phone

(309) 495-0200

Fax

(309) 676-6545

NPI assigned

Jul 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: glyn.jones@iss.directbygreenway.com

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1366462475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN STREET",
            "address_2": "3RD FLOOR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616062037",
            "telephone_number": "309-495-0200",
            "fax_number": "309-676-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN STREET",
            "address_2": "3RD FLOOR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616062037",
            "telephone_number": "309-495-0200",
            "fax_number": "309-676-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "GLYN",
        "middle_name": "E.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "036118115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "7215166",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036118115-1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECI",
            "identifier": "K37419",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie A Jones, NP
• David Omari Jones, M.D.
• Debra Jones, PTA
• Derek Jones
• Elaina Marie Jones
• Jacob Raymond Jones
• Jaime L Jones, MD
• Jeffrey Jones, N.P.
• Jennifer Jones, LMT
• Josie Jones, BSN, RN, IBCLC

• All providers in Peoria, IL
• Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.