DERRICK MICHAEL JONES (NPI# 1033759212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033759212 |
| Entity Type | Individual |
| Full Name | DERRICK MICHAEL JONES |
| Credential | PA-C |
| Practice Address |
12710 Se Division St Portland OR 97236-3134 |
| Mailing Address |
9701 Se Johnson Creek Blvd Apt B208 Happy Valley OR 97086-3671 |
| Practice Telephone | 5039883601 |
| Mailing Telephone | 9188597819 |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2020-01-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA196333 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750867776 | Derrick Wesley Jones | Specialist/Technologist | 275 W Broad St, Decatur, MS 39327-8985 | 2018-07-12 |
| 1326355405 | Derrick Jones | Pharmacist | 310 Fairview Ave, Ponca City, OK 74601-2001 | 2010-09-10 |
| 1689712655 | Derrick Jones | Radiology | 601 E Rollins St, Orlando, FL 32803 | 2007-02-02 |
| 1477669984 | Derrick D. Jones | Anesthesiology | 9150 Estate Thomas, Suite #106, St Thomas, VI 00802-2611 | 2006-08-21 |
| Street Address |
12710 SE DIVISION ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97236-3134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447298260 | Mary E Meadows | Family Medicine | 12710 Se Division St, Portland, OR 97236-3134 | 2006-06-03 |
| 1588281240 | Janet Trang Do | Pharmacist | 12710 Se Division St, Portland, OR 97236-3134 | 2020-06-29 |
| 1447893383 | Krista Kaufman | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2019-10-23 |
| 1174170682 | Amy Samantha Peck | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2019-08-20 |
| 1841776598 | Stephen Lawrence Erwin | Dentist | 12710 Se Division St, Portland, OR 97236-3134 | 2018-07-16 |
| 1083115612 | Multnomah County | Clinic/Center | 12710 Se Division St, Portland, OR 97236-3134 | 2018-02-28 |
| 1306394549 | Multnomah County Health Department | Clinic/Center | 12710 Se Division St, Portland, OR 97236-3134 | 2016-09-16 |
| 1952859555 | Neema Mohammad Nader | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2016-09-13 |
| 1447707625 | Margot Presley | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2016-09-06 |
| 1922485135 | Mary Caitlin Wells | Nurse Practitioner | 12710 Se Division St, Portland, OR 97236-3134 | 2015-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
| 1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
| 1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
| 1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
| 1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
| 1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
| 1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
| 1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
| Find all providers in zip 97236 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073081428 | Ishah Marie Price | Physician Assistant | 30 Preble St Apt 663, Portland, ME 04101-4939 | 2018-11-04 |
| 1740797166 | Joseph Something | Physician Assistant | 4800 Sw 76th Ave, Portland, OR 97225-1804 | 2018-01-08 |
| 1235687013 | Satchel Harry | Physician Assistant | 417 Sw 117th Ave Fl 2, Portland, OR 97225-5924 | 2016-09-21 |
| 1922551910 | Ashley Crowell | Physician Assistant | 949 Nw Overton St Unit 306, Portland, OR 97209 | 2016-07-26 |
| 1871982975 | Colin Storz | Physician Assistant | 3623 N Borthwick Ave, Portland, OR 97227-1218 | 2015-01-13 |
| 1275888729 | Stephanie Calvin | Physician Assistant | 782 College St, Portland, TN 37148-2120 | 2012-07-20 |
| 1174800031 | Carolyn Frances Farrell | Physician Assistant | 450 N Graham St, Portland, OR 97227-1682 | 2011-11-07 |
| 1316130198 | Ronald W Kessler | Physician Assistant | 632 Brighton Ave, Portland, ME 04102-1017 | 2007-08-24 |
| 1124210778 | Honey E.l. Marques | Physician Assistant | 16279 Se Division St, Portland, OR 97236-1971 | 2007-08-16 |
| 1124177902 | Dmitriy Shore | Physician Assistant | 10305 Sw Park Way Ste 300, Portland, OR 97225-5033 | 2007-01-09 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on DERRICK MICHAEL JONES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.