DPC Jewett LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

0024171097 Issued in VA

Legal business name

DPC JEWETT LLC

Practice address

702 City Center Blvd Ste C
Newport News, VA 23606-3096

Phone

(117) 576-7960

NPI assigned

Apr 4, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Donna P Clark, DNP, FNP-BC

Title

Owner/Medical Director

Phone

(757) 679-6058

Specialties & licenses 1

Addresses

Other names 2

• Dominion Patient Care Services Doing business as
• Dominion Patient Care Sevices Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Fessehaie Tekle, MD

  • Internal Medicine Physician
  • Hampton, VA
  • NPI 1518928100
  Medicare reassignment NPD
• Taneisha Patrice Gayles, FNP

  • Family Nurse Practitioner
  • Newport News, VA
  • NPI 1396512950
  NPD
• Alyssa Joyce Jessup, FNP

  • Family Nurse Practitioner
  • Norfolk, VA
  • NPI 1477161610
  NPD (past)
• Demeitrius M Whitehurst, B.A., CSAC, QMHP-A-C

  • Addiction (Substance Use Disorder) Counselor
  • Norfolk, VA
  • NPI 1407331135
  NPD (past)

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1366975633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 CITY CENTER BLVD STE C",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063096",
            "telephone_number": "175-767-9605",
            "fax_number": "757-926-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 CITY CENTER BLVD STE C",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063096",
            "telephone_number": "117-576-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DPC JEWETT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "757-679-6058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "VA",
            "license": "0024171097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dominion Patient Care Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dominion Patient Care Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dominion Patient Care Sevices",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tonika Downing
• Janet Doyle
• Melissa Sturgis Doyle
• Nicklaus Cary Doyle
• Travis Jay Dozier, PA
• Dpmstraleyprva,LLC
• Dpmstriflerprvallc
• DQS Communications Health Care Group
• Dr Matthew Slattery DDS
• Dr Robert Allan Shapiro PC

• Health Maintenance Organization in Newport News, VA
• Providers in Newport News, VA by specialty
• Health Maintenance Organization in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.