Individual provider Active NPI

Matthew Allan Jones, OD

  • Optometrist
  • Spokane, WA
National Provider Identifier
1679663090
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1597 Issued in WA
Practice address
124 E Rowan Ave
Ste 101
Spokane, WA 99207-1214
Phone
(509) 484-6550
Fax
(509) 484-0082
NPI assigned
Oct 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1597 WA Primary

Addresses

Primary practice location

124 E Rowan Ave
Ste 101
Spokane, WA 99207-1214

Mailing address

124 E Rowan Ave
Ste 101
Spokane, WA 99207-1214
Phone (509) 484-6550

Other identifiers 3

IdentifierTypeStateIssuer
2107902MedicaidWA
86252OtherWALABOR AND INDUSTRY
DC9602OtherWARAILROAD MEDICARE

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

State licenses

LicenseStateTypeSpecialty
1597WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew a Jones OD PS Optometrist PastSince Jan 1, 2005 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1679663090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E ROWAN AVE",
            "address_2": "STE 101",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071214",
            "telephone_number": "509-484-6550",
            "fax_number": "509-484-0082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E ROWAN AVE",
            "address_2": "STE 101",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992071214",
            "telephone_number": "509-484-6550",
            "fax_number": "509-484-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MATTHEW",
        "middle_name": "ALLAN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-14",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2107902",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRY",
            "identifier": "86252",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC9602",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.