Individual provider Active NPI

Elizabeth Marie Lewis, NP

  • Women's Health Nurse Practitioner
  • Olathe, KS
National Provider Identifier
1114262029
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
75719 Issued in KS
Practice address
407 S Clairborne Rd Ste 104
Olathe, KS 66062-1744
Phone
(913) 648-2266
Fax
(855) 348-8430
NPI assigned
Dec 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 2012024330 MO
Nurse Practitioner 363L00000X 111418 NE
Women's Health Nurse Practitioner 363LW0102X 75719 KS Primary

Addresses

Primary practice location

407 S Clairborne Rd Ste 104
Olathe, KS 66062-1744

Mailing address

405 S Clairborne Rd Ste 2
Olathe, KS 66062-1774
Phone (913) 730-3661

Other identifiers 1

IdentifierTypeStateIssuer
201139060BMedicaidKS

Other names 1

  • Elizabeth M. Nunnenkamp Other name

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
111418NEMDNurse Practitioner
75719KSMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1354579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1114262029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 S CLAIRBORNE RD STE 2",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621774",
            "telephone_number": "913-730-3661",
            "fax_number": "913-768-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S CLAIRBORNE RD STE 104",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621744",
            "telephone_number": "913-648-2266",
            "fax_number": "855-348-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-04",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MO",
            "license": "2012024330",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "111418",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KS",
            "license": "75719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201139060B",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "NUNNENKAMP",
            "middle_name": "M.",
            "credential": "WHNP-BC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Olathe, KS

Sources for this page

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