Active NPI
Jaylin R Lewis
- Personal Care Attendant
- Tallulah, LA
National Provider Identifier
1003662826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- License
- 1758001925
- Practice address
- 402 E Craig St
Tallulah, LA 71282-3718 - Phone
- (318) 574-9009
- NPI assigned
- Apr 24, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | 1758001925 | LA | Primary |
| Respite Care | 385H00000X | 770641488 | LA |
Addresses
Primary practice location
402 E Craig St
Tallulah, LA 71282-3718
Mailing address
402 E Craig St
Tallulah, LA 71282-3718
Phone (318) 574-9009
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 |
|---|---|---|---|
| 1758001925 | LA | MD | Personal Care Attendant |
| 770641488 | LA | MD | Respite Care |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713916800000",
"number": "1003662826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 E CRAIG ST",
"city": "TALLULAH",
"state": "LA",
"postal_code": "712823718",
"telephone_number": "318-574-9009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 E CRAIG ST",
"city": "TALLULAH",
"state": "LA",
"postal_code": "712823718",
"telephone_number": "318-574-9009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "JAYLIN",
"middle_name": "R",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-24",
"last_updated": "2024-04-24",
"certification_date": "2024-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": "LA",
"license": "1758001925",
"primary": true
},
{
"code": "385H00000X",
"taxonomy_group": "",
"desc": "Respite Care",
"state": "LA",
"license": "770641488",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallulah, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.