Individual provider Active NPI

Kathryn M. Lewis, PA-C

  • Physician Assistant
  • Bowling Green, KY
National Provider Identifier
1184600645
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA697 Issued in KY
Practice address
427 US 31W Byp Ste 204
Bowling Green, KY 42101-1703
Phone
(270) 721-7166
Fax
(270) 796-6860
NPI assigned
Dec 16, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA697 KY Primary

Addresses

Primary practice location

427 US 31W Byp Ste 204
Bowling Green, KY 42101-1703

Mailing address

427 US 31W Byp Ste 204
Bowling Green, KY 42101-1703
Phone (270) 721-7166

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20040727000760 KY Practitioner - Physician Assistant 6103896352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Kentucky College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

250 Park St
Bowling Green, KY 42101-1760
Phone (270) 781-7178

427 US 31W Byp
Bowling Green, KY 42101-1703
Phone (270) 796-8000

825 2ND Ave E
Suite C2
Bowling Green, KY 42101-1786

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA697KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc CurrentSince Nov 1, 2021 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Commonwealth Health Corporation Past Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

427 US 31W Byp
Ste 204
Bowling Green, KY 42101
Phone (270) 721-7166

Organizations & group practices 4

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 2

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": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1184600645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 US 31W BYP STE 204",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011703",
            "telephone_number": "270-721-7166",
            "fax_number": "270-796-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 US 31W BYP STE 204",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011703",
            "telephone_number": "270-721-7166",
            "fax_number": "270-796-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KATHRYN",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.