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NPI Code Detail

MEDICARE: XAVIER QUINCEY NEWSOME

MEDICARE: XAVIER QUINCEY NEWSOME
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker
2171M00000XCase Manager/Care CoordinatorOH
3171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962295501
Entity Type Code : Individual
Provider Name (Legal Business Name) : XAVIER QUINCEY NEWSOME
Provider Business Mailing Address
First Line : 2501 MAPLE GROVE RD UNIT 1
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-9527
Country : US
Telephone Number : 740-804-2188
Fax Number :
Provider Business Practice Location Address
First Line : 4653 E MAIN ST
Second Line :
City : WHITEHALL
State : OH
Zip : 43213-3298
Country : US
Telephone Number : 855-289-1722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2025
Last Update Date : 05/05/2026

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Directions to “ XAVIER QUINCEY NEWSOME ” Practice Location

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