Individual provider Active NPI

Kylee Lewis

  • Counselor
  • Springdale, AR
National Provider Identifier
1124401518
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
750 Mathias Dr
Springdale, AR 72762-0741
Phone
(479) 750-1272
Fax
(479) 750-1272
NPI assigned
Jul 2, 2015
Sex
Female
Sole proprietor
No

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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

750 Mathias Dr
Springdale, AR 72762-0741

Mailing address

602 N Walton Blvd
Bentonville, AR 72712-4576
Phone (479) 464-1060

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 2, 2015.

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1124401518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 N WALTON BLVD",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124576",
            "telephone_number": "479-464-1060",
            "fax_number": "479-271-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MATHIAS DR",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620741",
            "telephone_number": "479-750-1272",
            "fax_number": "479-750-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KYLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.