Individual provider Active NPI

Rebecca C Lewis, D.O.

  • Family Medicine Physician
  • Tahlequah, OK
National Provider Identifier
1174582407
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N8070 Issued in AR
Practice address
17611 South Muskogee Ave
Tahlequah, OK 74464-0000
Phone
(918) 207-4911
Fax
(918) 458-6221
NPI assigned
Mar 23, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X N8070 AR Primary

Addresses

Primary practice location

17611 South Muskogee Ave
Tahlequah, OK 74464-0000

Mailing address

PO Box 1426
Siloam Springs, AR 72761-1426
Phone (479) 524-8552

Other identifiers 1

IdentifierTypeStateIssuer
N8070OtherARARKANSAS LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190715003091 TX Practitioner - Family Practice 8325373228 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N8070ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Dec 30, 2019 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Mar 16, 2021 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Dec 30, 2019 Accepting new patients
Cherokee Nation Current Accepting new patients
Workwell Industrial Medicine Clinic Past Accepting new patients
Siloam Springs Clinic Company LLC Family Medicine Past Accepting new patients

Locations

101 S Moore Ave
Claremore, OK 74017
Phone (918) 342-6200

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1001 S 41st St E
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

395200 W 2900 Rd
Ochelata, OK 74051
Phone (918) 535-6000

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

821 Amohi Ln
Salina, OK 74365
Phone (918) 434-8500

301 S J T Stites St
Sallisaw, OK 74955
Phone (918) 774-1400

471688 Highway 51
Stilwell, OK 74960

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1174582407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1426",
            "city": "SILOAM SPRINGS",
            "state": "AR",
            "postal_code": "727611426",
            "telephone_number": "479-524-8552",
            "fax_number": "479-524-8593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17611 SOUTH MUSKOGEE AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744640000",
            "telephone_number": "918-207-4911",
            "fax_number": "918-458-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "REBECCA",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2021-03-09",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "N8070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS LICENSE",
            "identifier": "N8070",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

Verify at the official NPI Registry.