Individual provider Active NPI

Nicholas Lewis, PT, DPT

  • Physical Therapist
  • Burley, ID
National Provider Identifier
1073188660
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7276 Issued in NV
Practice address
1945 Hiland Ave
Burley, ID 83318-2714
Phone
(208) 647-0024
Fax
(208) 647-0239
NPI assigned
May 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7276 NV Primary

Addresses

Primary practice location

1945 Hiland Ave
Burley, ID 83318-2714

Mailing address

1411 Falls Ave E Ste 401
Twin Falls, ID 83301-3455
Phone (208) 969-9945

Other practice location 1

1024 8th St
Rupert, ID 83350-1306
Phone (208) 654-1444

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210701003504 ID Practitioner - Physical Therapist in Private Practice 0547661142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1945 Hiland Ave
Burley, ID 83318-2714
Phone (208) 647-0224

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7276NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wright Physical Therapy Limited Partnership Physical Therapist CurrentSince May 25, 2021 Accepting new patients
Wright Physical Therapy Limited Partnership Physical Therapist CurrentSince May 25, 2021 Accepting new patients

Locations

1945 Hiland Ave
Burley, ID 83318
Phone (208) 647-0024

1024 8th St
Rupert, ID 83350
Phone (208) 436-0734

1411 Falls Ave E
Ste 401
Twin Falls, ID 83301
Phone (208) 969-9945

1444 Falls Ave E
Twin Falls, ID 83301
Phone (208) 736-2574

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1073188660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E STE 401",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013455",
            "telephone_number": "208-969-9945",
            "fax_number": "208-944-0488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 HILAND AVE",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182714",
            "telephone_number": "208-647-0024",
            "fax_number": "208-647-0239"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1024 8th St",
            "address_purpose": "LOCATION",
            "city": "Rupert",
            "state": "ID",
            "postal_code": "833501306",
            "country_code": "US",
            "telephone_number": "208-654-1444",
            "fax_number": "208-643-4168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "NICHOLAS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "7276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burley, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.