Individual provider Active NPI

John Roland Jewell

  • Urgent Care Clinic/Center
  • Forest Hill, MD
National Provider Identifier
1619500550
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Practice address
2004 Rock Spring Rd
Forest Hill, MD 21050-2607
Phone
(443) 640-4524
NPI assigned
Feb 19, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X C0007456 MD
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X C0007456 MD
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

2004 Rock Spring Rd
Forest Hill, MD 21050-2607

Mailing address

414 Water St Apt 2301
Baltimore, MD 21202-3276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230614001439 DC Practitioner - Physician Assistant 1759749393 Reassigns benefits to 1 organization
I20230614001634 MD Practitioner - Physician Assistant 1759749393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians

Practice addresses (Care Compare)

1505 E Churchville Rd
Bel Air, MD 21014-4742

8000 Loch Raven Blvd
Towson, MD 21286-8337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C0007456MDMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries, LLC Single Specialty CurrentSince Jun 1, 2023 Accepting new patients
MNR Industries, LLC Urgent Care CurrentSince Jun 1, 2023 Accepting new patients
MNR Industries, LLC Urgent Care CurrentSince Jun 1, 2023 Accepting new patients
MNR Industries LLC Single Specialty Current Accepting new patients

Locations

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

1505 E Churchville Rd
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

Organizations & group practices 5

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": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1619500550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 WATER ST APT 2301",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212023276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2004 ROCK SPRING RD",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502607",
            "telephone_number": "443-640-4524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEWELL",
        "first_name": "JOHN",
        "middle_name": "ROLAND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-19",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "C0007456",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "MD",
            "license": "C0007456",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

Verify at the official NPI Registry.