Jewell Family And Elder Medicine Pa | |
1147 Ebenezer Rd Rock Hill SC 29732-2355 | |
(803) 329-6648 | |
(803) 985-4134 |
Full Name | Jewell Family And Elder Medicine Pa |
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Speciality | Family Medicine |
Location | 1147 Ebenezer Rd, Rock Hill, South Carolina |
Authorized Official Name and Position | James Lee Jewell (PRESIDENT) |
Authorized Official Contact | 8033296648 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Jewell Family And Elder Medicine Pa 1218 Auburndale Lane Rock Hill SC 29732 Ph: (803) 366-4818 | Jewell Family And Elder Medicine Pa 1147 Ebenezer Rd Rock Hill SC 29732-2355 Ph: (803) 329-6648 |
NPI Number | 1215982533 |
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Provider Enumeration Date | 05/24/2006 |
Last Update Date | 11/12/2014 |
Medicare PECOS PAC ID | 3173578259 |
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Medicare Enrollment ID | O20050322000719 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215982533 | NPI | - | NPPES |
GP2323 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QG0300X | Family Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
Provider Name | James Jewell |
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Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1063413136 PECOS PAC ID: 5193771285 Enrollment ID: I20100115000633 |
Provider Name | Erin Renee Smith |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255333779 PECOS PAC ID: 3779626718 Enrollment ID: I20100129000768 |
Provider Name | Jennifer T Stutts |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881084192 PECOS PAC ID: 1052630266 Enrollment ID: I20150508001340 |
Provider Name | Clarissa Latoya Carelock-lee |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184075475 PECOS PAC ID: 7911293154 Enrollment ID: I20160914000881 |
Provider Name | Anna Mataruka |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497204119 PECOS PAC ID: 1658653357 Enrollment ID: I20170112001618 |
Community Medicine Foundation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 Piedmont St, Rock Hill, SC 29730 Phone: 803-325-7744 | |