Organization Active NPI

Sewell Family Medicine and Urgent Care, P.C.

  • Family Medicine Physician
  • Carrollton, GA
National Provider Identifier
1841761533
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SEWELL FAMILY MEDICINE AND URGENT CARE, P.C.
Practice address
408 Maple St
Carrollton, GA 30117-3237
Phone
(678) 796-0804
Fax
(678) 796-0805
NPI assigned
Dec 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Authorized official

Name
Dr. Jeffery Kele Sewell, M.D.NPI 1598705071
Title
Physician/Owner
Phone
(678) 796-0804

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

408 Maple St
Carrollton, GA 30117-3237

Mailing address

408 Maple St
Carrollton, GA 30117-3237
Phone (678) 796-0804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181217000678 GA Part B Supplier - Clinic/Group Practice 9436494622 Receives reassigned benefits from 1 practitioner
Practice locations: Carrollton, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2156430Sewell Family Medicine408 Maple Street, Carrollton, GA 30117Certificate of waiverOct 17, 2026

National Provider Directory

National Provider Directory

Locations

928 S Park St
Ste H
Carrollton, GA 30117
Phone (414) 736-5830

408 Maple St
Carrollton, GA 30117
Phone (678) 796-0804

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1544054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1841761533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 MAPLE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173237",
            "telephone_number": "678-796-0804",
            "fax_number": "678-796-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 MAPLE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173237",
            "telephone_number": "678-796-0804",
            "fax_number": "678-796-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEWELL FAMILY MEDICINE AND URGENT CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-06",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "SEWELL",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "KELE",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "678-796-0804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.