Active NPI
Izaak J Lewis
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Mishawaka, IN
National Provider Identifier
1144816877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 26028496A
- Practice address
- 210 N Main St
Mishawaka, IN 46544-1411 - Phone
- (574) 259-1130
- NPI assigned
- Dec 16, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 26028496A | IN | Primary |
Addresses
Primary practice location
210 N Main St
Mishawaka, IN 46544-1411
Mailing address
210 N Main St
Mishawaka, IN 46544-1411
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 |
|---|---|---|---|
| 26028496A | IN | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nebula Transportation Services LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Private Vehicle
- Chicago, IL
- NPI 1437883832
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1608076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1608076800000",
"number": "1144816877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 N MAIN ST",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465441411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N MAIN ST",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465441411",
"telephone_number": "574-259-1130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "IZAAK",
"middle_name": "J",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-16",
"last_updated": "2020-12-16",
"certification_date": "2020-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "IN",
"license": "26028496A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.