JERRY L JONES MD PROFESSIONAL (NPI# 1578938676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578938676 |
| Entity Type | Organization |
| Organization Name | JERRY L JONES MD PROFESSIONAL |
| Practice Address |
400 Shadow Ln Suite 103 Las Vegas NV 89106-4363 |
| Practice Telephone | 7023845400 |
| Practice Fax Number | 7023840648 |
| Mailing Telephone | 7023845400 |
| Mailing Fax Number | 7023840648 |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2015-12-09 |
| Authorized Official Name | JERRY JONES (OWNER/PRESIDENT) |
| Authorized Official Telephone | 7023845400 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 4676 | NV | Other Service Providers |
| Street Address |
400 SHADOW LN SUITE 103 |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89106-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790767895 | Fred Doeleong Lee | Obstetrics & Gynecology | 400 Shadow Ln, Suite 207, Las Vegas, NV 89106-4363 | 2005-11-16 |
| 1124445283 | Ronny Soy | Registered Nurse | 400 Shadow Ln, Suite 106, Las Vegas, NV 89106-4363 | 2014-03-26 |
| 1386060457 | Sharon Brown Warren | Registered Nurse | 400 Shadow Ln, Las Vegas, NV 89106-4363 | 2014-03-12 |
| 1396169082 | Tanjara Bartley | Licensed Practical Nurse | 400 Shadow Ln, Suite 106, Las Vegas, NV 89106-4363 | 2014-02-14 |
| 1386067023 | Lorena Reyes De Corral | Registered Nurse | 400 Shadow Ln, Las Vegas, NV 89106-4363 | 2014-01-31 |
| 1912320177 | Latorsha Napoleon | Licensed Practical Nurse | 400 Shadow Ln, Suite 106, Las Vegas, NV 89106-4363 | 2014-01-23 |
| 1346663507 | Theresia Younes | Registered Nurse | 400 Shadow Ln, Suite # 106, Las Vegas, NV 89106-4363 | 2014-01-23 |
| 1629491980 | Ina Fincher | Registered Nurse | 400 Shadow Ln, Suite 106, Las Vegas, NV 89106-4363 | 2014-01-22 |
| 1528481884 | Ana Conroy | Registered Nurse | 400 Shadow Ln, Suite 106, Las Vegas, NV 89106-4363 | 2014-01-22 |
| 1619390986 | Linus Mubuifor | Registered Nurse | 400 Shadow Ln, 106, Las Vegas, NV 89106-4363 | 2014-01-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417555772 | Graciela Miranda Cocorpio | Technician | 820 Rancho Ln Suite #40, Las Vegas, NV 89106 | 2020-10-09 |
| 1679101679 | A Better You Wellness Center | Counselor | 320 W Monroe Street, Las Vegas, NV 89106 | 2020-03-27 |
| 1730725177 | Mariah La'neese Jones | Rehabilitation Practitioner | 400 Shadow Lane Ste 106, Las Vegas, NV 89106 | 2019-11-20 |
| 1417592841 | Lourdes Rita Apumayta-paredes | Technician | 820 Rancho Lane, Suite #40, Las Vegas, NV 89106 | 2019-11-08 |
| 1902456551 | Marisela Pena | Technician | 820 Rancho Ln., 25, Las Vegas, NV 89106 | 2019-09-16 |
| 1992368724 | Amber Nicole Mahajan | Nurse Practitioner | 2020 Wellness Way, Suite 300, Las Vegas, NV 89106 | 2019-04-17 |
| 1568924215 | Arlandrea Tarvins | Behavioral Analyst | 1048 Miller Ave, Las Vegas, NV 89106 | 2019-04-02 |
| 1427510361 | Erik Pennell | Student in an Organized Health Care Education/Training Program | 1542 Pinto Ln, 2nd Floor, Las Vegas, NV 89106 | 2019-04-01 |
| 1245702729 | Bruce Mark Babb | Technician | 820 Rancho Lane Ste #40, Las Vegas, NV 89106 | 2018-12-21 |
| 1639649213 | Antonio Ruiz Pelfort | Technician | 1951 Stella Lake St Suite 36, Las Vegas, NV 89106 | 2018-11-27 |
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| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710503305 | Michelle Mong Chan | Specialist | 5250 S Rainbow Blvd Unit 1138, Las Vegas, NV 89118-0630 | 2020-06-19 |
| 1821627878 | Anita Sidhu | Specialist | 9916 Pipestone St, Las Vegas, NV 89141-8667 | 2020-04-02 |
| 1316571144 | Jessica Lynn Bosch | Specialist | 2452 Desert Glen Dr, Las Vegas, NV 89134-8871 | 2020-03-02 |
| 1255963229 | Samantha Muro | Specialist | 4400 S Jones Blvd Unit 1017, Las Vegas, NV 89103-3336 | 2020-02-07 |
| 1417431024 | Misnelli Diaz-osorio | Specialist | 4714 E Flamingo Rd, Las Vegas, NV 89121-4709 | 2018-09-19 |
| 1265920011 | Mike Henley | Specialist | 8220 W Charleston Blvd, Las Vegas, NV 89117-1219 | 2018-04-27 |
| 1811485691 | George Alan Wheeler | Specialist | 2750 S Durango Dr Apt 2058, Las Vegas, NV 89117-2645 | 2018-04-26 |
| 1477082261 | Stephanie Staub | Specialist | 929 Boulder Mesa Dr Unit 102, Las Vegas, NV 89128-4151 | 2017-06-06 |
| 1124562327 | Medical Massage Rehab, LLC | Specialist | 945 Falconhead Ln Unit 202, Las Vegas, NV 89128-0332 | 2016-12-07 |
| 1396296323 | Kori Jeffries | Specialist | 8625 Dollhouse Dr, Las Vegas, NV 89145-4839 | 2016-10-14 |
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| 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.