Provider Demographics
NPI:1598286833
Name:JONES, JEREMY M
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:M
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-4119
Mailing Address - Country:US
Mailing Address - Phone:816-877-3480
Mailing Address - Fax:
Practice Address - Street 1:1106 N 155TH ST STE B
Practice Address - Street 2:
Practice Address - City:BASEHOR
Practice Address - State:KS
Practice Address - Zip Code:66007-7100
Practice Address - Country:US
Practice Address - Phone:913-662-7071
Practice Address - Fax:913-662-7072
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator