Shatara Jewell

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11044526 Issued in FL

Practice address

4573 Hawkins Blvd
Jacksonville, NC 28540-3852

Phone

(757) 287-1904

NPI assigned

Jan 10, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1768003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768003200000",
    "number": "1124986112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4573 HAWKINS BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285403852",
            "telephone_number": "757-287-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4573 HAWKINS BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285403852",
            "telephone_number": "757-287-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "SHATARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-10",
        "last_updated": "2026-01-10",
        "certification_date": "2026-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11044526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irene Elizabeth Jenkins, COTA
• Perry Samuel Jenkins Jr., PMHNP-BC
• Susan B Jensen, DNP, CPNP-PC
• Taylor Jerosimich
• Ashley Jerread
• Desai Victor Jiang, MD
• Larry Norman Johannessen, PHD MSW LCSW MDIV
• Erin Nichole Johanns, PT
• John M Romulus IV
• John M. Romulus DDS PA

• All providers in Jacksonville, NC
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2026; 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.