Individual provider Active NPI

Dalton Francis Lewis, PT

  • Physical Therapist
  • Lakeland, FL
National Provider Identifier
1063088052
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT37001 Issued in FL
Practice address
1430 Lakeland Hills Blvd
Lakeland, FL 33805-3202
Phone
(863) 680-7700
Fax
(866) 264-8519
NPI assigned
Jun 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT029256 PA
Physical Therapist 225100000X PT37001 FL Primary

Addresses

Primary practice location

1430 Lakeland Hills Blvd
Lakeland, FL 33805-3202

Mailing address

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3065
Phone (863) 680-7000

Other practice location 1

3037 Lakeland Hills Blvd Ste 5
Lakeland, FL 33805-2202
Phone (863) 688-6931

Other practice location 2

3900 S Florida Ave Ste 107
Lakeland, FL 33813-1150
Phone (863) 647-3665

Other practice location 3

1499 6th St NW
Winter Haven, FL 33881-2365
Phone (863) 293-7778

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dlewis22811@direct.watsonclinicad.com Watson Clinic LLP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240830003041 FL Practitioner - Physical Therapist in Private Practice 3971042102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watson Clinic LLPGroup PAC ID 1456258979, 365 clinicians

Practice addresses (Care Compare)

1430 Lakeland Hills Blvd
Lakeland, FL 33805-3202
Phone (863) 680-7337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT029256PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Watson Clinic LLP CurrentSince Aug 19, 2024 Accepting new patients

Locations

1430 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7337

1600 Lakeland Hills Blvd
Lakeland, FL 33805
Phone (863) 680-7190

Interoperability endpoints

  • Direct secure messaging: dlewis22811@direct.watsonclinicad.com

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": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1063088052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053065",
            "telephone_number": "863-680-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053202",
            "telephone_number": "863-680-7700",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3037 Lakeland Hills Blvd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338052202",
            "country_code": "US",
            "telephone_number": "863-688-6931",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3900 S Florida Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338131150",
            "country_code": "US",
            "telephone_number": "863-647-3665",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1499 6th St NW",
            "address_purpose": "LOCATION",
            "city": "Winter Haven",
            "state": "FL",
            "postal_code": "338812365",
            "country_code": "US",
            "telephone_number": "863-293-7778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "DALTON",
        "middle_name": "FRANCIS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-01",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029256",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT37001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dlewis22811@direct.watsonclinicad.com",
            "affiliation": "Y",
            "endpointDescription": "Direct Messaging Address",
            "affiliationName": "Watson Clinic LLP",
            "address_1": "1430 Lakeland Hills Blvd",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338053202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; 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.