Individual provider Active NPI

Evan Jones, M.D.

  • Ophthalmology Physician
  • North Charleston, SC
National Provider Identifier
1770666190
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
6656 Issued in SC
Practice address
3325 Ashley Phosphate Rd
North Charleston, SC 29418-8467
Phone
(843) 552-8220
NPI assigned
Oct 21, 2006
Last updated
Sep 15, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 6656 SC Primary

Addresses

Primary practice location

3325 Ashley Phosphate Rd
North Charleston, SC 29418-8467

Mailing address

3325 Ashley Phosphate Rd
North Charleston, SC 29418-8467
Phone (843) 552-8220

Other identifiers 1

IdentifierTypeStateIssuer
PC2154MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20120119000071 SC Practitioner - Ophthalmology 3072683424

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316044800000",
    "number": "1770666190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 ASHLEY PHOSPHATE RD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294188467",
            "telephone_number": "843-552-8220",
            "fax_number": "843-552-8666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 ASHLEY PHOSPHATE RD",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294188467",
            "telephone_number": "843-552-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "EVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-21",
        "last_updated": "2011-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "6656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC2154",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

Verify at the official NPI Registry.