Individual provider Active NPI

Rodney Duane Lewis, MD

  • Surgery Physician
  • Round Rock, TX
National Provider Identifier
1073519088
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G8901 Issued in TX
Practice address
7200 Wyoming SPGS
Ste 500
Round Rock, TX 78681-4307
Phone
(512) 244-0111
Fax
(512) 244-2479
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G8901 TX Primary

Addresses

Primary practice location

7200 Wyoming SPGS
Ste 500
Round Rock, TX 78681-4307

Mailing address

7200 Wyoming SPGS
Ste 500
Round Rock, TX 78681-4307
Phone (512) 244-0111

Other identifiers 2

IdentifierTypeStateIssuer
4210671OtherTXAETNA
110505801MedicaidTX

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

LicenseStateTypeSpecialty
G8901TXMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1073519088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 WYOMING SPGS",
            "address_2": "STE 500",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814307",
            "telephone_number": "512-244-0111",
            "fax_number": "512-244-2479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 WYOMING SPGS",
            "address_2": "STE 500",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814307",
            "telephone_number": "512-244-0111",
            "fax_number": "512-244-2479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "RODNEY",
        "middle_name": "DUANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "G8901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4210671",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110505801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.