MEDICARE: DR. LARHONDA R JONES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	109665	MO
2	2084P0804X	Child & Adolescent Psychiatry Physician	036-097194	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	481375	OTHER	MO	VALUE OPTIONS
2	15-44745	OTHER	MO	UNITED HEALTH CARE
3	370760015JON	OTHER	MO	PREMIERE BENEFITS
4	889413	OTHER	MO	MERCY CARE PLUS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	370760015JON	OTHER	MO	MERCY HEALTH PLAN
7	370760015JON	OTHER	MO	UNITY HEALTH SERVICES
8	479955	OTHER	MO	HEALTHLINK
9	P1505	OTHER	MO	PAS
10	127583	OTHER	MO	ANTHEM BLUE CROSS BLUE SH
11	889413	OTHER	MO	NOVASYS HEALTH
12	15-44745	OTHER	MO	UNITED BEHAVIORAL HEALTH
13	260205000	OTHER	MO	MAGELLAN BEHAVIORAL HEALT
14	481375	OTHER	MO	MH/SA CLAIMS
15	7769381	OTHER	MO	AETNA
16	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659470151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARHONDA R JONES M.D.

Provider Business Mailing Address
First Line	:	3394 MCKELVEY RD
Second Line	:	STE. 116
City	:	BRIDGETON
State	:	MO
Zip	:	63044-2531
Country	:	US
Telephone Number	:	314-209-0900
Fax Number	:	314-209-0912

Provider Business Practice Location Address
First Line	:	3394 MCKELVEY RD
Second Line	:	STE. 116
City	:	BRIDGETON
State	:	MO
Zip	:	63044-2531
Country	:	US
Telephone Number	:	314-209-0900
Fax Number	:	314-209-0912

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	07/08/2007

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