Active NPI
Bradley Jonathan Lewis, MD
- Family Medicine Physician
- Lancaster, OH
National Provider Identifier
1063414670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 35056043
- Practice address
- 1147 E Main St
Lancaster, OH 43130-4056 - Phone
- (740) 687-9173
- Fax
- (740) 689-3740
- NPI assigned
- Aug 12, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 35056043 | OH | Primary |
Addresses
Primary practice location
1147 E Main St
Lancaster, OH 43130-4056
Mailing address
1147 E Main St
Lancaster, OH 43130-4056
Phone (740) 687-9173
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0697929 | Medicaid | OH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35056043 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hocking Valley OB/GYN | Past | Accepting new patients |
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.
-
- Obstetrics & Gynecology Physician
- Lancaster, OH
- NPI 1063694867
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349740800000",
"number": "1063414670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1147 E MAIN ST",
"city": "LANCASTER",
"state": "OH",
"postal_code": "431304056",
"telephone_number": "740-687-9173",
"fax_number": "740-689-3740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1147 E MAIN ST",
"city": "LANCASTER",
"state": "OH",
"postal_code": "431304056",
"telephone_number": "740-687-9173",
"fax_number": "740-689-3740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "BRADLEY",
"middle_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-12",
"last_updated": "2012-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "35056043",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0697929",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.