Individual provider Active NPI

Jadevyonna Lewis, CPM, LM

  • Midwife
  • Apple Valley, CA
National Provider Identifier
1083279905
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
569 Issued in CA
Practice address
18031 US Highway 18 Ste B
Apple Valley, CA 92307-2152
Phone
(760) 985-4377
Fax
(770) 818-8126
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 569 CA Primary

Addresses

Primary practice location

18031 US Highway 18 Ste B
Apple Valley, CA 92307-2152

Mailing address

24978 Keator Rd
Apple Valley, CA 92307-2240
Phone (760) 985-4377

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
569CAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Embracing Oak Midwifery Current Accepting new patients
Embracing Oak Birth Center, LLC Current Accepting new patients

Locations

18031 US Highway 18
Ste B
Apple Valley, CA 92307
Phone (760) 242-5708

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1083279905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24978 KEATOR RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072240",
            "telephone_number": "760-985-4377",
            "fax_number": "760-818-8126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18031 US HIGHWAY 18 STE B",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072152",
            "telephone_number": "760-985-4377",
            "fax_number": "770-818-8126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JADEVYONNA",
        "credential": "CPM, LM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.