Organization Active NPI

Dana Marie Lewis, D.O., Inc

  • General Practice Physician
  • Grass Valley, CA
National Provider Identifier
1124124250
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
20A7088 Issued in CA
Legal business name
DANA MARIE LEWIS, D.O., INC
Practice address
10052 Alta Sierra Dr
Suite a
Grass Valley, CA 95949-6886
Phone
(530) 477-9100
Fax
(530) 477-2033
NPI assigned
Sep 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dana Marie Lewis, D.O.
Title
Business Owner
Phone
(530) 477-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X 20A7088 CA Primary

Addresses

Primary practice location

10052 Alta Sierra Dr
Suite a
Grass Valley, CA 95949-6886

Mailing address

10052 Alta Sierra Dr
Suite a
Grass Valley, CA 95949-6886
Phone (530) 477-9100

Other identifiers 1

IdentifierTypeStateIssuer
00AX70880MedicaidCA

National Provider Directory

National Provider Directory

Locations

10052 Alta Sierra Dr
Ste A
Grass Valley, CA 95949
Phone (530) 477-9100

150 Catherine Ln
Ste I
Grass Valley, CA 95945
Phone (530) 273-7400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124124250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10052 ALTA SIERRA DR",
            "address_2": "SUITE A",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959496886",
            "telephone_number": "530-477-9100",
            "fax_number": "530-477-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10052 ALTA SIERRA DR",
            "address_2": "SUITE A",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959496886",
            "telephone_number": "530-477-9100",
            "fax_number": "530-477-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANA MARIE LEWIS, D.O., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "530-477-9100",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "20A7088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX70880",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.