Ioly Tabita Lewis, PMHNP/ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP60785848 Issued in WA

Practice address

840 E Hill Ave
Moses Lake, WA 98837-2238

Phone

(509) 663-8711

NPI assigned

Jun 14, 2012

Reactivated

Aug 31, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Central Washington Health Services AssociationGroup PAC ID 4880504596, 708 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Confluence Health Hospital Hospital, Wenatchee, WA, CCN 500016

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: llewis64541@edirect.chehr.org

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.

• Central Washington Health Services Association

  • Emergency Medical Services (Emergency Medicine) Physician
  • Wenatchee, WA
  • NPI 1801937453
  Medicare reassignment Care Compare group NPD
• Frontier Behavioral Health

  • Community/Behavioral Health Agency
  • Spokane, WA
  • NPI 1861495327

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Lourdes Hospital LLC

  • Internal Medicine Physician
  • Pasco, WA
  • NPI 1659861060
  Medicare reassignment NPD
• Wenatchee Valley Hospital

  • Multi-Specialty Clinic/Center
  • Wenatchee, WA
  • NPI 1669719688
  Medicare reassignment NPD
• Central Washington Health Services Association

  • General Acute Care Hospital
  • Wenatchee, WA
  • NPI 1881642239
  NPD
• Wenatchee Valley Hospital

  • Clinical Medical Laboratory
  • Wenatchee, WA
  • NPI 1689916819
  NPD
• Lourdes Hospital LLC

  • Psychiatric Hospital
  • Richland, WA
  • NPI 1548342181
  NPD (past)
• Ozark Tri-County Health Care Consortium

  • Federally Qualified Health Center (FQHC)
  • Joplin, MO
  • NPI 1538151733
  NPD (past)

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

• Central Washington Health Services Association

  • General Acute Care Hospital
  • Wenatchee, WA
  • NPI 1306883228
  Care Compare affiliation

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1164784161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E HILL AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372238",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 S Division St",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992021510",
            "country_code": "US",
            "telephone_number": "509-838-4651",
            "fax_number": "509-363-2762",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "520 N 4th Ave",
            "address_2": "Lourdes Health Network",
            "address_purpose": "LOCATION",
            "city": "Pasco",
            "state": "WA",
            "postal_code": "99301",
            "country_code": "US",
            "telephone_number": "509-547-7704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "IOLY",
        "middle_name": "TABITA",
        "name_prefix": "Ms.",
        "credential": "PMHNP/ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2019-05-20",
        "deactivation_date": "2017-07-11",
        "reactivation_date": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60785848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164784167",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171037",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIC",
            "identifier": "AP60785848",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaeyeon Lee
• Jeffrey Scott Lee, DDS
• Corey Levi, LMT
• Christiian T Lewis, ARNP
• Erin K Lewis, PT
• Liberty Enterprises, LLC
• Gregg A Liedtka, D.M.D.
• Life Wellness Chiropractic LLC
• Lightening the Load Counseling PLLC
• Karen M Lindberg, MD

• Psychiatric/Mental Health Nurse Practitioner in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.