Active NPI
Shane David Jewell, LSW
- Social Worker
- Newark, OH
National Provider Identifier
1063994192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.1701365
- Practice address
- 2112 Cherry Valley Rd
Newark, OH 43055-1323 - Phone
- (740) 755-4500
- NPI assigned
- Sep 5, 2018
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | S.1701365 | OH | Primary |
Addresses
Primary practice location
2112 Cherry Valley Rd
Newark, OH 43055-1323
Mailing address
752 Moull St Apt B
Newark, OH 43055-2993
Phone (740) 877-9068
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.1701365 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536105600000",
"number": "1063994192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "752 MOULL ST APT B",
"city": "NEWARK",
"state": "OH",
"postal_code": "430552993",
"telephone_number": "740-877-9068"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2112 CHERRY VALLEY RD",
"city": "NEWARK",
"state": "OH",
"postal_code": "430551323",
"telephone_number": "740-755-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEWELL",
"first_name": "SHANE",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-05",
"last_updated": "2018-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1701365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.