Active NPI
Verne E Lewis, PHD
- Clinical Psychologist
- Las Vegas, NV
National Provider Identifier
1053317040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY0861
- Practice address
- 1980 Festival Plaza Dr
Las Vegas, NV 89135-2927 - Phone
- (323) 205-7088
- NPI assigned
- Jun 23, 2005
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY0861 | NV | Primary |
Addresses
Primary practice location
1980 Festival Plaza Dr
Las Vegas, NV 89135-2927
Mailing address
1980 Festival Plaza Dr
Las Vegas, NV 89135-2927
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39109100 | Medicaid | WI |
Other names 1
- Dr. V. Ellsworth Lewis
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1830 | WI | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736121600000",
"number": "1053317040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1980 FESTIVAL PLAZA DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891352927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1980 FESTIVAL PLAZA DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891352927",
"telephone_number": "323-205-7088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "VERNE",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-23",
"last_updated": "2025-01-06",
"certification_date": "2025-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NV",
"license": "PY0861",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39109100",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "V.",
"last_name": "LEWIS",
"middle_name": "ELLSWORTH",
"prefix": "DR.",
"credential": "PH.D.",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.