Active NPI
Thomas Perez Jewell, M.A.
- Student in an Organized Health Care Education/Training Program
- Martinez, CA
National Provider Identifier
1568517647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- IMF51524
- Practice address
- 100 Glacier Dr
Martinez, CA 94553-4824 - Phone
- (925) 646-2110
- Fax
- (925) 646-2024
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | IMF51524 | CA | Primary |
Addresses
Primary practice location
100 Glacier Dr
Martinez, CA 94553-4824
Mailing address
597 Stewart Way
Rio Vista, CA 94571-1290
Phone (707) 330-2964
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF51524 | CA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568517647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "597 STEWART WAY",
"city": "RIO VISTA",
"state": "CA",
"postal_code": "945711290",
"telephone_number": "707-330-2964",
"fax_number": "925-646-2024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 GLACIER DR",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945534824",
"telephone_number": "925-646-2110",
"fax_number": "925-646-2024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEWELL",
"first_name": "THOMAS",
"middle_name": "PEREZ",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "IMF51524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, CA
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.