Raven Simone Pew, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

506589 Issued in OH

Practice address

2737 Youngstown Rd SE
Warren, OH 44484-5002

Phone

(330) 369-8022

NPI assigned

Dec 11, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Raven Trickett Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/wecaremoreohio/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• First Step Recovery of Warren LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Warren, OH
  • NPI 1255736450
  NPD (past)
• First Step Recovery of Warren LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Warren, OH
  • NPI 1346120979
  NPD (past)

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1467967687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2737 YOUNGSTOWN RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444845002",
            "telephone_number": "330-369-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 YOUNGSTOWN RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444845002",
            "telephone_number": "330-369-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEW",
        "first_name": "RAVEN",
        "middle_name": "SIMONE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "166401",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "506589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAVEN",
            "last_name": "TRICKETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teriney Peterson-Lee
• Amanda Peterson
• Amber Peterson, CDCA
• Angela Maris Pettenati, MD
• Emily Pettitt
• Terry B Philibin, D.D.S., M.S.
• Phillip Maiden M.D.
• Phillips Healthcare LLC (Nightingale Care)
• Ajjiaree Nekeyia Phillips, NP
• Charles Phillips

• Registered Nurse in Warren, OH
• Providers in Warren, OH by specialty
• Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.