Individual provider Active NPI

Tony S Jewell, LPCC

  • Professional Counselor
  • Campbellsville, KY
National Provider Identifier
1205282829
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
105388 Issued in KY
Practice address
16 Ingram Avenue
Campbellsville, KY 42718-1621
Phone
(844) 435-0900
Fax
(270) 858-4029
NPI assigned
May 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 105388 KY Primary

Addresses

Primary practice location

16 Ingram Avenue
Campbellsville, KY 42718-1621

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other practice location 1

377 Heatherton Circle Rd
Greensburg, KY 42743-9790
Phone (270) 405-1420

Other identifiers 2

IdentifierTypeStateIssuer
13831487OtherKYCAQH
7100403130MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20250801002975 KY Practitioner - Mental Health Counselor 5991960965 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medical Center Inc Current Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jul 9, 2025 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jul 9, 2025 Accepting new patients
Best Care Family Practice LLC CurrentSince Jun 25, 2009 Accepting new patients

Locations

6350 Old Scottsville Rd
Alvaton, KY 42122
Phone (270) 843-8067

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

300 Ingram Ave
Campbellsville, KY 42718
Phone (270) 465-4431

2705 Hodgenville Rd
Campbellsville, KY 42718
Phone (270) 849-3616

106 Ingram Ave
Campbellsville, KY 42718

1207 E Broadway St
Campbellsville, KY 42718
Phone (270) 465-2877

704 Columbia Hwy
Greensburg, KY 42743
Phone (270) 932-4203

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Best Care Family Practice LLCGreensburg, KY, CCN B03945 Rural health clinic 5% Or Greater Direct Ownership Interest
Corporate Officer
Operational/Managerial Control
Jun 25, 2009
Jun 25, 2009
Jun 25, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

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": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1205282829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 INGRAM AVENUE",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427181621",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "377 Heatherton Circle Rd",
            "address_purpose": "LOCATION",
            "city": "Greensburg",
            "state": "KY",
            "postal_code": "427439790",
            "country_code": "US",
            "telephone_number": "270-405-1420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "TONY",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-12",
        "last_updated": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "105388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13831487",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100403130",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

Verify at the official NPI Registry.