Individual provider Active NPI

Shawn D Jones, M.D.

  • Pediatrics Physician
  • Council Bluffs, IA
National Provider Identifier
1952418592
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
36226 Issued in IA
Practice address
1 Edmundson PL
Council Bluffs, IA 51503-4658
Phone
(712) 396-4310
Fax
(712) 396-7069
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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 36226 IA Primary

Addresses

Primary practice location

1 Edmundson PL
Council Bluffs, IA 51503-4658

Mailing address

PO Box 3755
Omaha, NE 68103-0755
Phone (402) 354-2100

Other identifiers 2

IdentifierTypeStateIssuer
47068731712MedicaidNE
1952418592MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20050923000973 IA Practitioner - Pediatric Medicine 2163456591 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Clinic IncGroup PAC ID 4880506062, 557 clinicians

Practice addresses (Care Compare)

1 Edmundson PL
Council Bluffs, IA 51503-4658
Phone (712) 396-4000

600 S 4TH St
Council Bluffs, IA 51503-6586
Phone (712) 242-1131

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36226IAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Clinic Inc Pediatrics CurrentSince Dec 17, 2009 Accepting new patients
Pottawattamie County Targeted Medicaid Case Management Current Accepting new patients
Pottawattamie County CurrentSince Mar 1, 2020 Accepting new patients
Alegent Health Bergan Mercy Health System Past Accepting new patients
Jennie Edmundson Memorial Hospital Past Accepting new patients

Locations

600 S 4th St
Council Bluffs, IA 51503
Phone (712) 242-1131

1 Edmundson Pl
Ste 300
Council Bluffs, IA 51503

1 Edmundson Pl
Council Bluffs, IA 51503
Phone (712) 396-4000

825 S 169th St
Omaha, NE 68118
Phone (402) 354-3370

Interoperability endpoints

  • Direct secure messaging: shawn.jones@direct.nmhs.org

Organizations & group practices 5

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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1952418592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3755",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681030755",
            "telephone_number": "402-354-2100",
            "fax_number": "402-354-2155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EDMUNDSON PL",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515034658",
            "telephone_number": "712-396-4310",
            "fax_number": "712-396-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "SHAWN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "36226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47068731712",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952418592",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.