Individual provider Active NPI

Jean M. Amon, M.D.

  • Pediatrics Physician
  • Yuma, AZ
National Provider Identifier
1689658163
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
33054 Issued in AZ
Practice address
2400 S Avenue a
Yuma, AZ 85364-7170
Phone
(928) 336-3213
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 33054 AZ Primary

Addresses

Primary practice location

2400 S Avenue a
Yuma, AZ 85364-7170

Mailing address

2400 S Avenue a
Yuma, AZ 85364-7127
Phone (928) 344-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050907001015 AZ Practitioner - Pediatric Medicine 5799717062 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33054AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yuma Regional Medical Center CurrentSince Apr 13, 2021 Accepting new patients
Yuma Regional Medical Center CurrentSince Apr 13, 2021 Accepting new patients
San Luis Walk-in Clinic, Inc. Past Accepting new patients

Locations

2359 S 22nd Dr
Ste 2
Yuma, AZ 85364
Phone (928) 344-4800

2400 S Avenue A
Yuma, AZ 85364
Phone (928) 336-7100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

Organizations & group practices 3

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1689658163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 S AVENUE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647127",
            "telephone_number": "928-344-2000",
            "fax_number": "928-722-6113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S AVENUE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647170",
            "telephone_number": "928-336-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMON",
        "first_name": "JEAN",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "33054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.