1790779965 NPI number — MS. CHERYL DENISE JONES B.S. PT

Table of content: (NPI 1275370561)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790779965 NPI number — MS. CHERYL DENISE JONES B.S. PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
CHERYL
Provider Middle Name:
DENISE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
B.S. PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790779965
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7700 OLD BRANCH AVE
Provider Second Line Business Mailing Address:
E108
Provider Business Mailing Address City Name:
CLINTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20735-1628
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-856-3011
Provider Business Mailing Address Fax Number:
301-856-3013

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7700 OLD BRANCH AVE
Provider Second Line Business Practice Location Address:
E108
Provider Business Practice Location Address City Name:
CLINTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20735-1628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-856-3011
Provider Business Practice Location Address Fax Number:
301-856-3013
Provider Enumeration Date:
09/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  17199 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 043618988 . This is a "INTEGRATED HEALTH PLAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 219933 . This is a "ANTHEM BC/BS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 043618988 . This is a "CIGNET HEALTH PLAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 043618988 . This is a "FIRST HEALTH NETWORK" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2973167 . This is a "AETNA HMO" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 85339 . This is a "AMERIGROUP" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: S371 . This is a "CAREFIRST INDIVIDUAL PROV" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2363202 . This is a "UNITED HEALTHCARE INSURAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7506378 . This is a "AETNA PPO PROVIDER NUMBER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 043618988 . This is a "TRICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: KBG3KE . This is a "CAREFIRST GROUP #" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 544483 . This is a "NCPPO (NCAS)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 6401009 . This is a "UNITED HEALTHCARE MID-ATL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 800615 . This is a "US DEPT OF LABOR (ENERGY)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 000165100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 204450700 . This is a "US DEPT OF LABOR (ACS)" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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