Provider Demographics
NPI:1326178815
Name:JONES, NOAH JESSE (MD)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:JESSE
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 PARK ST SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4609
Mailing Address - Country:US
Mailing Address - Phone:703-591-1280
Mailing Address - Fax:703-591-1445
Practice Address - Street 1:2901 TELESTAR CT.
Practice Address - Street 2:#200
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1262
Practice Address - Country:US
Practice Address - Phone:703-573-3494
Practice Address - Fax:703-573-5353
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244963207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1326178815Medicaid
MD416808900Medicaid
VAP00806639OtherRAILROAD MEDICARE VA
DCP00739962OtherRAILROAD MEDICARE
DC068882800Medicaid
DCP00739962OtherRAILROAD MEDICARE
MD416808900Medicaid