Active NPI
David Jewett
- School Psychologist
- Glendale, AZ
National Provider Identifier
1801924972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 3622575
- Practice address
- 6330 W Thunderbird Rd
Glendale, AZ 85306-4002 - Phone
- (623) 486-6000
- NPI assigned
- Mar 1, 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 3622575 | AZ | Primary |
Addresses
Primary practice location
6330 W Thunderbird Rd
Glendale, AZ 85306-4002
Mailing address
12922 W la Vina Dr
Sun City West, AZ 85375-2674
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 133346 | Medicaid | AZ |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3622575 | AZ | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peoria Unified School District #11 | Past | Accepting new patients | |
| Peoria Unified School District | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Case Management Agency
- Glendale, AZ
- NPI 1518123397
-
- Local Education Agency (LEA)
- Glendale, AZ
- NPI 1790807626
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1801924972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12922 W LA VINA DR",
"city": "SUN CITY WEST",
"state": "AZ",
"postal_code": "853752674"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6330 W THUNDERBIRD RD",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853064002",
"telephone_number": "623-486-6000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEWETT",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "AZ",
"license": "3622575",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "133346",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.