Individual ProviderShanericka Reshonet JonesNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3998 Fair Ridge Drive, Suite 320, Fairfax, VA 22033-2921(703) 295-9360PECOS EnrollmentBased on the most recent information from CMS, provider Shanericka Reshonet Jones does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:15 AM.Profile DetailsProvider ID1730325762Provider TypeIndividualFull NameJones, Shanericka ReshonetTitleMissCredentialCRNAGenderFemaleSole ProprietorYesEnumeration Date12/22/2008Last Updated8/28/2013Contact InformationPractice LocationPractice Address3998 Fair Ridge Drive, Suite 320, Fairfax, VA 22033-2921Phone(703) 295-9360Fax(703) 295-9369Mailing LocationMailing AddressPO Box 37090, Baltimore, MD 21297-3090Phone(703) 295-9360Fax(703) 295-9369Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense0024171084VirginiaCode163W00000XDescriptionRegistered NurseNursing Service ProvidersLicense157231TennesseeCode367500000XDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense13884TennesseeProvider IdentifiersIDDescriptionIssuerIDP00711618DescriptionOtherIssuerRAILROAD MEDICARETennesseeID04870087DescriptionMedicaidIssuerUnlistedMississippiID1511595DescriptionMedicaidIssuerUnlistedTennesseeID1730325762DescriptionOtherIssuerCHAMPUS/HUMANA TRICAREID186289001DescriptionMedicaidIssuerUnlistedArkansasID4205212DescriptionOtherIssuerBLUE CROSSTennessee