Individual provider Active NPI

Adrian Matthew Jones

  • Marriage & Family Therapist
  • Boise, ID
National Provider Identifier
1548849896
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
7761369 Issued in ID
Practice address
1075 E Park Blvd
Boise, ID 83712-7722
Phone
(208) 381-5970
Fax
(208) 381-5971
NPI assigned
Apr 5, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 7761369 ID Primary
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

1075 E Park Blvd
Boise, ID 83712-7722

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

596 N 260 W
Vineyard, UT 84059-4813
Phone (208) 695-1589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 16, 2024 through Jan 16, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7761369IDMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1548849896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 E PARK BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837127722",
            "telephone_number": "208-381-5970",
            "fax_number": "208-381-5971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "596 N 260 W",
            "address_purpose": "LOCATION",
            "city": "Vineyard",
            "state": "UT",
            "postal_code": "840594813",
            "country_code": "US",
            "telephone_number": "208-695-1589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "ADRIAN",
        "middle_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "ID",
            "license": "7761369",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.