Individual provider Active NPI

James Lee Jewell, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Rock Hill, SC
National Provider Identifier
1063413136
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
12269 Issued in SC
Practice address
1147 Ebenezer Rd
Rock Hill, SC 29732-2355
Phone
(803) 329-6648
Fax
(803) 985-4134
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X 12269 SC Primary

Addresses

Primary practice location

1147 Ebenezer Rd
Rock Hill, SC 29732-2355

Mailing address

1218 Auburndale LN
Rock Hill, SC 29732-9600
Phone (803) 366-4818

Other identifiers 1

IdentifierTypeStateIssuer
122691/GP2323MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100115000633 SC Practitioner - Geriatric MedicinePractitioner - Family Practice 5193771285

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12269SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Health Connection Geriatric Medicine Past Accepting new patients
Andrea Hope Speech Pathology LLC PastSince Nov 30, 2001 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1063413136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1218 AUBURNDALE LN",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297329600",
            "telephone_number": "803-366-4818",
            "fax_number": "803-366-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 EBENEZER RD",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297322355",
            "telephone_number": "803-329-6648",
            "fax_number": "803-985-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "JAMES",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "SC",
            "license": "12269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122691/GP2323",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

Verify at the official NPI Registry.