Individual provider Active NPI

Kevin James Lewis

  • Homemaker
  • Cannonball, ND
National Provider Identifier
1124966940
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
Practice address
1047 Bluejay St.
Cannonball, ND 58528
Phone
(701) 854-7117
NPI assigned
Mar 23, 2026
Sex
Male
Sole proprietor
Yes

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
Homemaker 376J00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

1047 Bluejay St.
Cannonball, ND 58528

Mailing address

1047 Bluejay St.
Cannonball, ND 58528
Phone (701) 854-7117

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 23, 2026.

{
    "created_epoch": "1774224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1124966940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1047 BLUEJAY ST.",
            "city": "CANNONBALL",
            "state": "ND",
            "postal_code": "58528",
            "telephone_number": "701-854-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1047 BLUEJAY ST.",
            "city": "CANNONBALL",
            "state": "ND",
            "postal_code": "58528",
            "telephone_number": "701-854-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KEVIN",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-23",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cannonball, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2026; 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.