Individual provider Active NPI

Jackson Christopher Lewis

  • Orthopedic Physical Therapist
  • Shreveport, LA
National Provider Identifier
1013847003
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
12341 Issued in LA
Practice address
663 Jordan St
Shreveport, LA 71101-4748
Phone
(318) 918-8619
NPI assigned
May 21, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 12341 LA Primary

Addresses

Primary practice location

663 Jordan St
Shreveport, LA 71101-4748

Mailing address

663 Jordan St
Shreveport, LA 71101-4748
Phone (318) 222-8892

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260602002607 LA Practitioner - Physical Therapist in Private Practice 9335610203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

663 Jordan St
Shreveport, LA 71101-4748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12341LAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brewer Physical Therapy & Associates LLC CurrentSince May 21, 2026 Accepting new patients
Select Physical Therapy Texas Limited Partnership PastSince May 21, 2026 Accepting new patients

Locations

663 Jordan St
Shreveport, LA 71101
Phone (318) 222-8892

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1779321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1013847003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014748",
            "telephone_number": "318-222-8892",
            "fax_number": "318-222-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014748",
            "telephone_number": "318-918-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JACKSON",
        "middle_name": "CHRISTOPHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-05-21",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "LA",
            "license": "12341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; 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.