Jewel Community Care LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

JEWEL COMMUNITY CARE LLC

Practice address

105 Cedar St Ste C
Monroe, NC 28110-3054

Phone

(877) 775-3935

NPI assigned

Jul 25, 2021

Last updated

Jul 25, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

JEWEL COMMUNITY CARE LLCAs reported in NPPES

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

Authorized official

Name

Ms. Crystal D Bush, LCSW LCAS LISW-CPNPI 1265532527

Title

Clinical Director

Phone

(984) 292-4235

Specialties & licenses 1

Addresses

Other names 1

• Jewel Community Care- Union Other name

Electronic endpoints 1

Tax ID family

Jewel Community Care LLC2 organizations share this tax ID, including this one

Part of

Jewel Community Care LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jewel Community Care LLC

  • Community/Behavioral Health Agency
  • Haw River, NC
  • NPI 1558034181
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Jewel Community Care LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Reidsville, NC
  • NPI 1841813177
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Crystal Denee Bush, LCSW, LCAS, LISW-CP

  • Clinical Social Worker
  • Durham, NC
  • NPI 1265532527
  NPD Authorized official

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

{
    "created_epoch": "1627171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627171200000",
    "number": "1639842883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 SUN STAR DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276107281",
            "telephone_number": "919-649-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CEDAR ST STE C",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281103054",
            "telephone_number": "877-775-3935"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1235 S Scales St",
            "address_purpose": "LOCATION",
            "city": "Reidsville",
            "state": "NC",
            "postal_code": "273205630",
            "country_code": "US",
            "telephone_number": "877-775-3935 x1",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JEWEL COMMUNITY CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEWEL COMMUNITY CARE LLC",
        "enumeration_date": "2021-07-25",
        "last_updated": "2021-07-25",
        "certification_date": "2021-07-25",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "984-292-4235",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW LCAS LISW-CP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Kno2",
            "affiliation": "N",
            "endpointDescription": "Cloud-based server",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1235 S Scales St",
            "city": "Reidsville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "273205630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Jewel Community Care- Union",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Harvette Carmelle Jenkins-Bah, MD
• Heather Jenkins, PT, DPT, ATP
• Jessica Whitney Jenkins, LMBT, MM
• Mindy Renee Jenkins
• Ariel Hyemin Jeong, DMD
• Elizabeth Jimenez-Rivera
• Joel L Penegar OD PA
• John Stuart Williams, DDS, P.a.
• John Walsh DDS PA (Dentistry of the Carolinas)
• Harvie Vance Johnson

• Community/Behavioral Health Agency in Monroe, NC
• Providers in Monroe, NC by specialty
• Community/Behavioral Health Agency in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2021; 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.