Individual provider Active NPI

Jewell E Gist, LCSWA

  • Clinical Social Worker
  • Lenoir, NC
National Provider Identifier
1073140695
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P014425 Issued in NC
Practice address
2415 Morganton Blvd SW
Lenoir, NC 28645-9691
Phone
(828) 394-5563
Fax
(828) 394-5418
NPI assigned
Mar 24, 2020
Last updated
Apr 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P014425 NC
Clinical Social Worker 1041C0700X P014425 NC Primary

Addresses

Primary practice location

2415 Morganton Blvd SW
Lenoir, NC 28645-9691

Mailing address

2415 Morganton Blvd SW
Lenoir, NC 28645-9691
Phone (828) 394-5563

Other names 1

  • Jewell Gist Professional name

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL MORGANTON Health Information Exchange (HIE)
Other URL MORGANTON

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220815000594 NC Practitioner - Clinical Social Worker 2365825932 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P014425NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rha Health Services, in CurrentSince Jul 20, 2022 Accepting new patients
Rha Health Services Inc Current Accepting new patients
Rha Health Services, Inc CurrentSince Jul 20, 2022 Accepting new patients

Locations

211 Perimeter Center Pkwy NE
Ste 750
Atlanta, GA 30346

211 S Centennial St
High Point, NC 27260
Phone (336) 841-0143

2415 Morganton Blvd SW
Lenoir, NC 28645
Phone (828) 394-5563

395 3rd Ave SW
Taylorsville, NC 28681
Phone (828) 848-2515

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1073140695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 MORGANTON BLVD SW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286459691",
            "telephone_number": "828-394-5563",
            "fax_number": "828-394-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 MORGANTON BLVD SW",
            "city": "LENOIR",
            "state": "NC",
            "postal_code": "286459691",
            "telephone_number": "828-394-5563",
            "fax_number": "828-394-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIST",
        "first_name": "JEWELL",
        "middle_name": "E",
        "credential": "LCSWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-24",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "P014425",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P014425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "MORGANTON",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "MORGANTON",
            "address_1": "2415 Morganton Blvd SW",
            "city": "Lenoir",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286459691",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "MORGANTON",
            "affiliation": "N",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2415 Morganton Blvd SW",
            "city": "Lenoir",
            "state": "NC",
            "country_code": "US",
            "postal_code": "286459691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JEWELL",
            "last_name": "GIST",
            "credential": "LCSWA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lenoir, NC

Sources for this page

Verify at the official NPI Registry.