Individual provider Active NPI

Jewell S Mabery, ANP

  • Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1073557773
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
900215 Issued in NC
Practice address
3125 Poplarwood CT
Aspen BLDG, Suite 100
Raleigh, NC 27604-1084
Phone
(800) 632-6074
Fax
(866) 341-7509
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 900215 NC Primary

Addresses

Primary practice location

3125 Poplarwood CT
Aspen BLDG, Suite 100
Raleigh, NC 27604-1084

Mailing address

616 Westside Dr
Newton, NC 28658-3622
Phone (828) 465-2719

Other names 1

  • Jewell Stewart Former name

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
900215NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paradigm Health Psychiatric SRV, LLC PastSince Feb 8, 2011 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.

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073557773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 WESTSIDE DR",
            "city": "NEWTON",
            "state": "NC",
            "postal_code": "286583622",
            "telephone_number": "828-465-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT",
            "address_2": "ASPEN BLDG, SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041084",
            "telephone_number": "800-632-6074",
            "fax_number": "866-341-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABERY",
        "first_name": "JEWELL",
        "middle_name": "S",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "900215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEWELL",
            "last_name": "STEWART",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.