Individual provider Active NPI

Samuel Leroy Jones Jr., RN

  • Community Health Registered Nurse
  • Fort Rucker, AL
National Provider Identifier
1528148210
Registry record updated Jul 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
RN085457 Issued in AZ
Practice address
301 Andrews Avenue
Fort Rucker, AL 36362
Phone
(334) 432-7356
Fax
(334) 255-7663
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN085457 AZ Primary

Addresses

Primary practice location

301 Andrews Avenue
Fort Rucker, AL 36362

Mailing address

301 Andrews Avenue
Fort Rucker, AL 36362
Phone (334) 432-7356

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN085457AZMDCommunity Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1528148210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ANDREWS AVENUE",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "36362",
            "telephone_number": "334-432-7356",
            "fax_number": "334-255-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ANDREWS AVENUE",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "36362",
            "telephone_number": "334-432-7356",
            "fax_number": "334-255-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SAMUEL",
        "middle_name": "LEROY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "AZ",
            "license": "RN085457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Rucker, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; 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.