Active NPI
Tamison Jewett, MD
- Clinical Genetics (M.D.) Physician
- Winston Salem, NC
National Provider Identifier
1770567729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Genetics (M.D.) Physician
- License
- 34637
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-0001 - Phone
- (336) 716-2255
- NPI assigned
- Dec 2, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Genetics (M.D.) Physician | 207SG0201X | 34637 | NC | Primary |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-0001
Mailing address
PO Box 344
Winston Salem, NC 27102-0344
Phone (336) 716-2255
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6713033 | Medicaid | VA | |
| 8945946 | Medicaid | NC | |
| 4509049 | Other | AETNA | |
| Q34638 | Medicaid | SC | |
| 55928 | Other | NC | MEDCOST |
| 2001736000 | Medicaid | WV | |
| 2710 | Other | NC | PARTNERS |
| 45946 | Other | NC | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100327000245 | NC | Practitioner - Pediatric Medicine | 0042346207 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34637 | NC | MD | Clinical Genetics (M.D.) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210291200000",
"number": "1770567729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 344",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271020344",
"telephone_number": "336-716-2255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-716-2255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEWETT",
"first_name": "TAMISON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-02",
"last_updated": "2008-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207SG0201X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Genetics (M.D.)",
"state": "NC",
"license": "34637",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6713033",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8945946",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4509049",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q34638",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDCOST",
"identifier": "55928",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2001736000",
"state": "WV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARTNERS",
"identifier": "2710",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "45946",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.