Individual provider Active NPI

Charles M Lewis

  • Massage Therapist
  • Aurora, CO
National Provider Identifier
1053183194
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0007690 Issued in CO
Practice address
2101 S Blackhawk St Ste 245
Aurora, CO 80014-1492
Phone
(720) 667-4959
Fax
(720) 667-4960
NPI assigned
Oct 23, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 0007690 CO Primary

Addresses

Primary practice location

2101 S Blackhawk St Ste 245
Aurora, CO 80014-1492

Mailing address

2101 S Blackhawk St Ste 245
Aurora, CO 80014-1492
Phone (720) 667-4959

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

LicenseStateTypeSpecialty
0007690COMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
SMRT Pain Relief Center Massage Therapist CurrentSince Oct 29, 2023 Accepting new patients

Locations

2101 S Blackhawk St
Ste 245
Aurora, CO 80014
Phone (720) 667-4959

Organizations & group practices 1

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": "1698019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1053183194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 S BLACKHAWK ST STE 245",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141492",
            "telephone_number": "720-667-4959",
            "fax_number": "720-667-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S BLACKHAWK ST STE 245",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800141492",
            "telephone_number": "720-667-4959",
            "fax_number": "720-667-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "CHARLES",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "0007690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.