Individual provider Active NPI

John N Jewell, MD

  • Emergency Medicine Physician
  • Spartanburg, SC
National Provider Identifier
1417958265
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.082052 Issued in OH
Practice address
101 E Wood St
Spartanburg, SC 29303-3040
Phone
(864) 560-7025
Fax
(864) 560-7388
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2006-01133 NC
Emergency Medicine Physician 207P00000X 31469 SC
Emergency Medicine Physician 207P00000X 35.082052 OH Primary

Addresses

Primary practice location

101 E Wood St
Spartanburg, SC 29303-3040

Mailing address

PO Box 277700
Atlanta, GA 30384-7700
Phone (440) 717-6600

Other identifiers 7

IdentifierTypeStateIssuer
64064165MedicaidKY
000000353335OtherOHANTHEM
143KCOtherNCBCBS OF NC PROVIDER NUMBE
314699MedicaidSC
4685180MedicaidMI
5905296MedicaidNC
2378663MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041201000740 OH Practitioner - Emergency Medicine 8426013400 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2006-01133NCMDEmergency Medicine Physician
35.082052OHMDEmergency Medicine Physician
31469SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professional Services, Inc. Emergency Medicine CurrentSince Nov 28, 2010 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Carolina Coast Emergency Physicians LLC Emergency Medicine Past Accepting new patients
Epmg of Ohio Inc P a Emergency Medicine PastSince Aug 3, 2025 Accepting new patients

Locations

2139 Auburn Ave
Cincinnati, OH 45219
Phone (513) 585-0406

18697 Bagley Rd
Middleburg Heights, OH 44130
Phone (440) 816-8000

885 N Sandusky Ave
Upper Sandusky, OH 43351
Phone (419) 294-4991

1250 S Washington St
Van Wert, OH 45891
Phone (419) 232-2077

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1417958265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 277700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303847700",
            "telephone_number": "440-717-6600",
            "fax_number": "440-546-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E WOOD ST",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033040",
            "telephone_number": "864-560-7025",
            "fax_number": "864-560-7388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "JOHN",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2006-01133",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "31469",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.082052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64064165",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000353335",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC PROVIDER NUMBE",
            "identifier": "143KC",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "314699",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4685180",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905296",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2378663",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.