Charles Deron Lewis

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CHARLES DERON LEWIS

Doing business as

Reliable Healthcare

Practice address

310 N Adams Street
Carthage, TX 75633

Phone

(903) 694-2285

Fax

(903) 694-9658

NPI assigned

Nov 3, 2005

Last updated

May 11, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Charles Deron Lewis

Title

Owner/Proprietor

Phone

(903) 694-2285

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Reliable Healthcare Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1073504437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "75633",
            "telephone_number": "903-694-2285",
            "fax_number": "903-694-9658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N ADAMS STREET",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "75633",
            "telephone_number": "903-694-2285",
            "fax_number": "903-694-9658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES DERON LEWIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "DERON",
        "authorized_official_title_or_position": "OWNER/PROPRIETOR",
        "authorized_official_telephone_number": "903-694-2285",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010568601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "530941",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016517701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reliable Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Carthage, TX
• Providers in Carthage, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2012; 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.