Individual provider Active NPI

Merral B Lewis, M.D.

  • Family Medicine Physician
  • Evansville, IN
National Provider Identifier
1124021555
Registry record updated Mar 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01027625A Issued in IN
Practice address
350 W Columbia St
Ste 440
Evansville, IN 47710-1782
Phone
(812) 425-2461
Fax
(812) 424-7254
NPI assigned
May 31, 2005
Last updated
Mar 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01027625A IN Primary

Addresses

Primary practice location

350 W Columbia St
Ste 440
Evansville, IN 47710-1782

Mailing address

PO Box 1230
Evansville, IN 47706-1230
Phone (812) 425-2461

Other identifiers 1

IdentifierTypeStateIssuer
100242820MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc. Current Accepting new patients
Deaconess Clinic Inc. Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
Deaconess Clinic Inc Family Medicine CurrentSince Jul 1, 2019 Accepting new patients
Deaconess Hospital Inc PastSince Jan 1, 1990 Accepting new patients

Locations

350 W Columbia St
Ste 440
Evansville, IN 47710
Phone (812) 425-2461

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1124021555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1230",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477061230",
            "telephone_number": "812-425-2461",
            "fax_number": "812-424-7254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W COLUMBIA ST",
            "address_2": "STE 440",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101782",
            "telephone_number": "812-425-2461",
            "fax_number": "812-424-7254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MERRAL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01027625A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100242820",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.