Active NPI
Victoria Lea Jones, PA
- Physician Assistant
- Waconia, MN
National Provider Identifier
1679595052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 8802
- Practice address
- 875 E Main St
Waconia, MN 55387-1081 - Phone
- (952) 442-0333
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 8802 | MN | Primary |
Addresses
Primary practice location
875 E Main St
Waconia, MN 55387-1081
Mailing address
8024 Autumn Ridge Way
Chanhassen, MN 55317-8449
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 889638100 | Medicaid | MN |
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
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462320000000",
"number": "1679595052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8024 AUTUMN RIDGE WAY",
"city": "CHANHASSEN",
"state": "MN",
"postal_code": "553178449"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "875 E MAIN ST",
"city": "WACONIA",
"state": "MN",
"postal_code": "553871081",
"telephone_number": "952-442-0333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "VICTORIA",
"middle_name": "LEA",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-24",
"last_updated": "2016-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "8802",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "889638100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waconia, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.