Individual provider Active NPI

Bailey E Lewis, ATC

  • Sports Medicine (Emergency Medicine) Physician
  • Annapolis, MD
National Provider Identifier
1063993889
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Emergency Medicine) PhysicianTaxonomy code 207PS0010X
License
A0000955 Issued in MD
Practice address
566 Brownson Rd
Annapolis, MD 21402-5006
Phone
(269) 319-9216
NPI assigned
Aug 29, 2018
Last updated
Aug 29, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Emergency Medicine) Physician 207PS0010X A0000955 MD Primary

Addresses

Primary practice location

566 Brownson Rd
Annapolis, MD 21402-5006

Mailing address

1234 Seminole Dr
Arnold, MD 21012-2614
Phone (269) 319-9216

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
A0000955MDMDSports Medicine (Emergency Medicine) Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1063993889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 SEMINOLE DR",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210122614",
            "telephone_number": "269-319-9216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "566 BROWNSON RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214025006",
            "telephone_number": "269-319-9216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "BAILEY",
        "middle_name": "E",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PS0010X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Sports Medicine",
            "state": "MD",
            "license": "A0000955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.