Active NPI
Ron Allen Jewett
- Behavior Technician
- Berlin, MD
National Provider Identifier
1013445402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 10514 Racetrack Rd Ste G
Berlin, MD 21811-3241 - Phone
- (208) 308-4578
- NPI assigned
- May 30, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
10514 Racetrack Rd Ste G
Berlin, MD 21811-3241
Mailing address
10 53Rd St Unit 303
Ocean City, MD 21842-7228
Phone (208) 308-4578
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588102552 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ocean Front Counseling | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Behavior Analyst
- Berlin, MD
- NPI 1588102552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496102400000",
"number": "1013445402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 53RD ST UNIT 303",
"city": "OCEAN CITY",
"state": "MD",
"postal_code": "218427228",
"telephone_number": "208-308-4578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10514 RACETRACK RD STE G",
"city": "BERLIN",
"state": "MD",
"postal_code": "218113241",
"telephone_number": "208-308-4578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEWETT",
"first_name": "RON",
"middle_name": "ALLEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-30",
"last_updated": "2017-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1588102552",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Berlin, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.