Active NPI
Peter David Jones, MD
- Internal Medicine Physician
- Willimantic, CT
National Provider Identifier
1619934296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 019026
- Practice address
- 14 Quarry St
Willimantic, CT 06226-1232 - Phone
- (860) 423-8020
- Fax
- (860) 456-8288
- NPI assigned
- Apr 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 019026 | CT | Primary |
Addresses
Primary practice location
14 Quarry St
Willimantic, CT 06226-1232
Mailing address
14 Quarry St
Willimantic, CT 06226-1232
Phone (860) 423-8020
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00119026300 | Other | CT | BLUECARE FAMILY PLAN |
| 782359 | Other | CT | CONNECTICARE |
| 030188 | Other | CT | HEALTHNET OF THE NE |
| WIP002 | Other | CT | OXFORD HEALTH PLAN |
| 001190263 | Medicaid | CT | |
| 010019026CT01 | Other | CT | ANTHEM BC/BS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019026 | CT | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1260921600000",
"number": "1619934296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 QUARRY ST",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062261232",
"telephone_number": "860-423-8020",
"fax_number": "860-456-8288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 QUARRY ST",
"city": "WILLIMANTIC",
"state": "CT",
"postal_code": "062261232",
"telephone_number": "860-423-8020",
"fax_number": "860-456-8288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "PETER",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-27",
"last_updated": "2009-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "019026",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE FAMILY PLAN",
"identifier": "00119026300",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "782359",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET OF THE NE",
"identifier": "030188",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH PLAN",
"identifier": "WIP002",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001190263",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "010019026CT01",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Willimantic, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.