JACOB JEWELL (NPI# 1902419104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902419104 |
| Entity Type | Individual |
| Full Name | JACOB JEWELL |
| Credential | FNP-C |
| Practice Address |
20952 E 12 Mile Rd Ste 200 Saint Clair Shores MI 48081-3203 |
| Practice Telephone | 5867714820 |
| Practice Fax Number | 5867716620 |
| Mailing Telephone | 5867714820 |
| Mailing Fax Number | 5867716620 |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-09-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
4704301664 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
20952 E 12 MILE RD STE 200 |
| City | SAINT CLAIR SHORES |
| State | MI |
| Zip Code | 48081-3203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265498117 | Dinesh John Telang | Urology | 20952 E 12 Mile Rd Ste 200, Saint Clair Shores, MI 48081 | 2006-04-20 |
| 1407269822 | Emily Suzanne Oshnock | Physician Assistant | 20952 E 12 Mile Rd Ste 200, Saint Clair Shores, MI 48081 | 2014-06-03 |
| 1053674101 | Robert Lewis Elgin | Urology | 20952 E 12 Mile Rd Ste 200, Saint Clair Shores, MI 48081-3203 | 2012-06-22 |
| 1245476670 | Michigan Institute of Urology Laboratory | Clinical Medical Laboratory | 20952 E 12 Mile Rd Ste 200, Saint Clair Shores, MI 48081-3203 | 2009-01-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750865416 | Saint Clair Family Pharmacy LLC | Pharmacy | 28001 Harper Ave., Saint Clair Shores, MI 48081 | 2018-09-19 |
| 1669995783 | Terra Laquay Ginther | Social Worker | 28800 Harper Ave Ste A, Saint Clair Shores, MI 48081 | 2017-07-20 |
| 1245676998 | Julia Hanson | Social Worker | 27941 Harper Ave., Suite 105, St. Clair Shores, MI 48081 | 2013-05-21 |
| 1760731301 | Life Transition Service | Community/Behavioral Health | 21031 Sunnydale, St. Clair Shore, MI 48081 | 2012-08-29 |
| 1477868792 | William Burr Wood | Pharmacist | 21000 Twelve Milerd., St Clair Shores, MI 48081 | 2010-08-11 |
| 1508094350 | Dominic Anthony Garrisi | Anesthesiology | 21018 Bon Brae, St. Clair Shores, MI 48081 | 2009-06-30 |
| 1992947022 | Karen Ostrowski-thomas | Occupational Therapist | 22442 Bayview, St. Clair Shores, MI 48081 | 2009-04-06 |
| 1891979787 | Chirag Rachhadia | Physical Therapist | 29150 Harper Avenue, St. Clair Shores, MI 48081 | 2007-12-27 |
| 1598955114 | Donna Warner Manczak | Psychologist | 21400 E Eleven Mil Rd, St Clair Shores, MI 48081 | 2007-07-30 |
| 1467652347 | Sumit Narayanprasad Fogla | Family Medicine | 21400 E Eleven Mile Road, St. Clair Shores, MI 48081 | 2007-07-19 |
| Find all providers in zip 48081 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376194597 | Ashley Imbrunnone | Nurse Practitioner | 20952 E 12 Mile Rd # 101, Saint Clair Shores, MI 48081-3200 | 2019-09-28 |
| 1760031645 | Stephanie Kayser | Nurse Practitioner | 22619 Millenbach St, Saint Clair Shores, MI 48081-2598 | 2019-09-04 |
| 1063880573 | Ronald August Bonaventura Jr. | Nurse Practitioner | 22432 Harper Lake Ave, Saint Clair Shores, MI 48080-4041 | 2015-09-14 |
| 1033595749 | Jennifer Kulinski | Nurse Practitioner | 24800 Ursuline St, Saint Clair Shores, MI 48080-3195 | 2015-08-04 |
| 1215587100 | Florence Arabia P Acebedo | Nurse Practitioner | 24345 Harper Ave, Saint Clair Shores, MI 48080-1285 | 2019-09-12 |
| 1053895193 | Ayesha Massey Bennett | Nurse Practitioner | 25200 Little Mack Ave, Saint Clair Shores, MI 48081-2116 | 2018-09-24 |
| 1871072546 | Meagan Torrey Smoyer | Nurse Practitioner | 24345 Harper Ave, Saint Clair Shores, MI 48080-1285 | 2018-08-13 |
| 1053897496 | Meghan Martinovski | Nurse Practitioner | 25200 Little Mack Ave, Saint Clair Shores, MI 48081-2116 | 2018-07-18 |
| 1770090409 | Tara Marie Carter | Nurse Practitioner | 23715 Little Mack Ave Ste 100, Saint Clair Shores, MI 48080-1181 | 2018-01-03 |
| 1801331210 | Katja N Tandarich | Nurse Practitioner | 21000 E 12 Mile Rd, Suite 111, Saint Clair Shores, MI 48081-1116 | 2016-12-21 |
| Find all providers in SAINT CLAIR SHORES | ||||
| City | SAINT CLAIR SHORES |
| Zip Code | 48081 |
Please comment or provide details below to improve the information on JACOB JEWELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.