Active NPI
Kenneth Randall Lewis, EDD, LMFT
- Marriage & Family Therapist
- Orlando, FL
National Provider Identifier
1043655236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT 2615
- Practice address
- 1802 N Alafaya TRL
Suite 115
Orlando, FL 32826-4716 - Phone
- (407) 766-0020
- NPI assigned
- May 2, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MT 2615 | FL | Primary |
Addresses
Primary practice location
1802 N Alafaya TRL
Suite 115
Orlando, FL 32826-4716
Mailing address
1802 N Alafaya TRL
Suite 115
Orlando, FL 32826-4716
Phone (407) 766-0020
Other names 1
- Dr. Randy Lewis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT 2615 | FL | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367452800000",
"number": "1043655236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1802 N ALAFAYA TRL",
"address_2": "SUITE 115",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328264716",
"telephone_number": "407-766-0020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1802 N ALAFAYA TRL",
"address_2": "SUITE 115",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328264716",
"telephone_number": "407-766-0020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "KENNETH",
"middle_name": "RANDALL",
"name_prefix": "Dr.",
"credential": "EDD, LMFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-02",
"last_updated": "2013-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT 2615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "RANDY",
"last_name": "LEWIS",
"prefix": "DR.",
"credential": "EDD, LMFT",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.