Individual provider Active NPI

Maggie Lewis, FNP-C

  • Family Nurse Practitioner
  • Florissant, MO
National Provider Identifier
1023433745
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2014004544 Issued in MO
Practice address
3433 N Hwy 67
Florissant, MO 63033
Phone
(314) 755-1822
NPI assigned
Mar 4, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2014004544 MO Primary
Nurse Practitioner 363L00000X 209.014868 IL

Addresses

Primary practice location

3433 N Hwy 67
Florissant, MO 63033

Mailing address

3433 North Highway 67
Florissant, MO 63033
Phone (314) 755-1822

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141223000606 MO Practitioner - Nurse Practitioner 2062735012 Reassigns benefits to 2 organizations
I20161227001877 IL Practitioner - Nurse Practitioner 2062735012 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.014868ILMDNurse Practitioner
2014004544MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Services of Memphis, P.C. Nurse Practitioner CurrentSince Dec 1, 2016 Accepting new patients
Mercy East Ambulatory Services LLC PastSince Aug 15, 2021 Accepting new patients
Rezilient Olh PA Nurse Practitioner PastSince Oct 16, 2022 Accepting new patients
Our Urgent Care, LLC PastSince Dec 9, 2019 Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

2 Progress Point Pkwy
O Fallon, MO 63368
Phone (636) 344-1000

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

Interoperability endpoints

  • Direct secure messaging: maggie.lewis.1@25598.direct.athenahealth.com

Organizations & group practices 5

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": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1023433745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 NORTH HIGHWAY 67",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "63033",
            "telephone_number": "314-755-1822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 N HWY 67",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "63033",
            "telephone_number": "314-755-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MAGGIE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-04",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2014004544",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.014868",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

Verify at the official NPI Registry.