NPIMap

Individual provider Active NPI

Jeremy C Lewis, DO

  • Family Medicine Physician
  • Newport, WA
National Provider Identifier
1164514436
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00001708 Issued in WA
Practice address
714 W Pine St
Newport, WA 99156-9046
Phone
(509) 447-2441
Fax
(509) 447-0456
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X OP00001708 WA
Family Medicine Physician 207Q00000X OP00001708 WA Primary

Addresses

Primary practice location

714 W Pine St
Newport, WA 99156-9046

Mailing address

714 W Pine St
Newport, WA 99156-9046
Phone (509) 447-2441

Other identifiers 1

IdentifierTypeStateIssuer
8319212MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100701000756 WA Practitioner - Family Practice 0042341208 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pend Oreille County Public Hospital District No 1Group PAC ID 3274431184, shared by 5 NPIs, 31 clinicians

Practice addresses (Care Compare)

714 W Pine St
Newport, WA 99156-9046
Phone (509) 447-2441

Hospital & facility affiliations

  • Assured Home Health Home health agency, Spokane Valley, WA, CCN 507044
  • Eden Home Health Home health agency, Ponderay, ID, CCN 137122
  • Newport Community Hospital Hospital, Newport, WA, CCN 501310
  • Bonner General Hospital Hospital, Sandpoint, ID, CCN 131328
  • Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054
  • Providence Holy Family Hospital Hospital, Spokane, WA, CCN 500077
  • Newport Community Hospital Nursing home, CCN 50Z310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 Emergency Medicine CurrentSince Oct 11, 2022 Accepting new patients
Pend Oreille County Public Hospital District No 1 CurrentSince Oct 22, 2000 Accepting new patients
Pend Oreille County Public Hospital District No 1 Current Accepting new patients
Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 Current Accepting new patients
Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 CurrentSince Oct 11, 2022 Accepting new patients
Pend Oreille County Public Hospital District No 1 Emergency Medicine CurrentSince Oct 22, 2000 Accepting new patients
Pend Oreille County Public Hospital District No 1 Family Medicine Past Accepting new patients
Douglas, Grant, Lincoln & Okanogan Counties Public Hospital District 6 Past Accepting new patients
Pend Oreille County Public Hospital District No 1 Family Medicine Past Accepting new patients

Locations

411 Fortuyn Rd
Grand Coulee, WA 99133
Phone (509) 633-1753

714 W Pine St
Bldg C
Newport, WA 99156
Phone (509) 447-3139

714 W Pine St
Newport, WA 99156
Phone (509) 447-2441

Interoperability endpoints

  • Direct secure messaging: jlewis345029@wm.providencedirect.org

Organizations & group practices 9

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1164514436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 W PINE ST",
            "city": "NEWPORT",
            "state": "WA",
            "postal_code": "991569046",
            "telephone_number": "509-447-2441",
            "fax_number": "509-447-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W PINE ST",
            "city": "NEWPORT",
            "state": "WA",
            "postal_code": "991569046",
            "telephone_number": "509-447-2441",
            "fax_number": "509-447-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JEREMY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "OP00001708",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8319212",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, WA

Sources for this page

Verify at the official NPI Registry.