Individual provider Active NPI

Thomas Elias Blair Jones, MD

  • Family Medicine Physician
  • De Queen, AR
National Provider Identifier
1700883402
Registry record updated Dec 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E0842 Issued in AR
Practice address
128 Highway 71 N
De Queen, AR 71832-3706
Phone
(870) 642-8961
Fax
(870) 642-2171
NPI assigned
Jul 7, 2005
Last updated
Dec 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E0842 AR Primary
Family Medicine Physician 207Q00000X 19680 OK

Addresses

Primary practice location

128 Highway 71 N
De Queen, AR 71832-3706

Mailing address

128 Highway 71 N
De Queen, AR 71832-3706
Phone (870) 642-8961

Other identifiers 3

IdentifierTypeStateIssuer
1125327OtherARHIPPA CONFIRMATION NO.
5K030OtherARBCBS
629182001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20080630000694 AR Practitioner - Family PracticePractitioner - General Practice 1658443080 Practice locations: De Queen, AR

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E0842ARMDFamily Medicine Physician
19680OKMDFamily Medicine Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323820800000",
    "number": "1700883402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 HIGHWAY 71 N",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718323706",
            "telephone_number": "870-642-8961",
            "fax_number": "870-642-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 HIGHWAY 71 N",
            "city": "DE QUEEN",
            "state": "AR",
            "postal_code": "718323706",
            "telephone_number": "870-642-8961",
            "fax_number": "870-642-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "THOMAS",
        "middle_name": "ELIAS BLAIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E0842",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "19680",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIPPA CONFIRMATION NO.",
            "identifier": "1125327",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5K030",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "629182001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in De Queen, AR

Sources for this page

Verify at the official NPI Registry.