Individual provider Active NPI

Marcus Isaac Lewis

  • School Registered Nurse
  • El Paso, TX
National Provider Identifier
1164279287
Registry record updated May 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
1104661 Issued in TX
Practice address
5933 Via Robles LN
El Paso, TX 79912-6615
Phone
(915) 861-3100
NPI assigned
May 6, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 1104661 TX Primary

Addresses

Primary practice location

5933 Via Robles LN
El Paso, TX 79912-6615

Mailing address

1325 Washington St
Anthony, NM 88021-8846
Phone (575) 882-6101

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

LicenseStateTypeSpecialty
1104661TXMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714953600000",
    "number": "1164279287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 WASHINGTON ST",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "880218846",
            "telephone_number": "575-882-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5933 VIA ROBLES LN",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799126615",
            "telephone_number": "915-861-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MARCUS",
        "middle_name": "ISAAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-05-06",
        "certification_date": "2024-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "TX",
            "license": "1104661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2024; 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.