Active NPI
Micah Y Lewis, OTR/L, CLT
- Occupational Therapist
- Blair, NE
National Provider Identifier
1114435393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1689
- Practice address
- 4586 Crest Ridge Loop
Blair, NE 68008-6406 - Phone
- (402) 800-7002
- NPI assigned
- Jan 22, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2298 | IA | |
| Occupational Therapist | 225X00000X | 1689 | NE | Primary |
Addresses
Primary practice location
4586 Crest Ridge Loop
Blair, NE 68008-6406
Mailing address
4586 Crest Ridge Loop
Blair, NE 68008-6406
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1689 | NE | MD | Mental Health Counselor |
| 2298 | IA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720569600000",
"number": "1114435393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4586 CREST RIDGE LOOP",
"city": "BLAIR",
"state": "NE",
"postal_code": "680086406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4586 CREST RIDGE LOOP",
"city": "BLAIR",
"state": "NE",
"postal_code": "680086406",
"telephone_number": "402-800-7002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "MICAH",
"middle_name": "Y",
"credential": "OTR/L, CLT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-22",
"last_updated": "2024-07-10",
"certification_date": "2024-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "2298",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "1689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blair, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.