Individual provider Active NPI

Steve A Jewett

  • Optician
  • Belle Fourche, SD
National Provider Identifier
1225054828
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
Practice address
1830 5TH Ave
Belle Fourche, SD 57717-1405
Phone
(605) 892-4411
Fax
(605) 892-6227
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
Yes

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X Primary

Addresses

NPPES NPI Registry

Primary practice location

1830 5TH Ave
Belle Fourche, SD 57717-1405

Mailing address

1830 5TH Avenue
Belle Fourche, SD 57717-1405
Phone (605) 892-4411

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
9280613MedicaidSD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225054828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 5TH AVENUE",
            "city": "BELLE FOURCHE",
            "state": "SD",
            "postal_code": "577171405",
            "telephone_number": "605-892-4411",
            "fax_number": "605-892-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 5TH AVE",
            "city": "BELLE FOURCHE",
            "state": "SD",
            "postal_code": "577171405",
            "telephone_number": "605-892-4411",
            "fax_number": "605-892-6227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWETT",
        "first_name": "STEVE",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9280613",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belle Fourche, SD

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.