Active NPI
Robert Buckner Jones Jr., M.D.
- Psychiatry Physician
- Nisswa, MN
National Provider Identifier
1841355906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 28731
- Practice address
- 4300 Lower Roy Lake Rd
Nisswa, MN 56468-2726 - Phone
- (218) 330-5310
- NPI assigned
- Dec 27, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 28731 | MN | Primary |
Addresses
Primary practice location
4300 Lower Roy Lake Rd
Nisswa, MN 56468-2726
Mailing address
PO Box 652
Brainerd, MN 56401-0652
Phone (218) 330-5310
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28731 | MN | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841355906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 652",
"city": "BRAINERD",
"state": "MN",
"postal_code": "564010652",
"telephone_number": "218-330-5310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 LOWER ROY LAKE RD",
"city": "NISSWA",
"state": "MN",
"postal_code": "564682726",
"telephone_number": "218-330-5310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JONES",
"first_name": "ROBERT",
"middle_name": "BUCKNER",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "28731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nisswa, MN
- Dennis Dean Hins, RPH
- Jennifer Vaughn Therapy Services LLC
- Craig Brian Johnson, DDS
- Derrek Johnson, D.C.
- Krista Johnson, O.T.
- Christopher Gordon Klabo, D.D.S.
- Cathy Liane, MSLP
- Lighthouse Counseling, Cathy Liane, M.S.L.P.,LLC
- Luke Waln Dentistry, PC (Nisswa Smiles)
- Minnesota Holistic Clinic LLC (Minnesota Holistic Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.