NPIMap

Individual provider Active NPI

Shirley Eileen Jones, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1740273085
Registry record updated Jun 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22666 Issued in AL
Practice address
6856 103Rd St
Jacksonville, FL 32210-6877
Phone
(904) 777-0616
Fax
(904) 111-0688
NPI assigned
Aug 23, 2005
Last updated
Jun 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 049042 GA
Family Medicine Physician 207Q00000X 22666 AL Primary
Family Medicine Physician 207Q00000X ME113465 FL

Addresses

Primary practice location

6856 103Rd St
Jacksonville, FL 32210-6877

Mailing address

6856 103Rd St
Jacksonville, FL 32210-6877
Phone (904) 777-0616

Other identifiers 3

IdentifierTypeStateIssuer
000882846CMedicaidGA
14KY6OtherFLBCBS
005941800MedicaidFL

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)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
22666ALMDPharmacist
ME113465FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
After Hours Family Medicine Hoover Family Medicine Past Accepting new patients
Jefferson Clinic, P.C. Family Medicine Past Accepting new patients
Cooperative Healthcare Services Inc Family Medicine Past Accepting new patients
Southeast Georgia Health System, Inc. Past Accepting new patients

Organizations & group practices 4

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": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402617600000",
    "number": "1740273085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6856 103RD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322106877",
            "telephone_number": "904-777-0616",
            "fax_number": "904-111-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6856 103RD ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322106877",
            "telephone_number": "904-777-0616",
            "fax_number": "904-111-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SHIRLEY",
        "middle_name": "EILEEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2014-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "049042",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "22666",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME113465",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000882846C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "14KY6",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005941800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2014; 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.