NPIMap

Individual provider Active NPI

Dustin James Lewis, FNP

  • Family Nurse Practitioner
  • Redding, CA
National Provider Identifier
1194004150
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP20860 Issued in CA
Practice address
691 Maraglia St Ste C
Redding, CA 96002-1029
Phone
(530) 222-3287
Fax
(530) 222-8547
NPI assigned
Aug 9, 2011
Last updated
Oct 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP20860 CA Primary

Addresses

Primary practice location

691 Maraglia St Ste C
Redding, CA 96002-1029

Mailing address

691 Maraglia St Ste C
Redding, CA 96002-1029
Phone (530) 605-4680

Other identifiers 1

IdentifierTypeStateIssuer
NP20860OtherCAFNP LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20110909002695 CA Practitioner - Nurse Practitioner 3375713951 Practice locations: Redding, CA

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

691 Maraglia St
Suite C
Redding, CA 96002-1029
Phone (530) 222-3287

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
24.55 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
81.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP20860CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marla Elkins Advanced Practice Registered Nursing Inc. Family PastSince Apr 6, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1312848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1194004150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "691 MARAGLIA ST STE C",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021029",
            "telephone_number": "530-605-4680",
            "fax_number": "530-605-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 MARAGLIA ST STE C",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021029",
            "telephone_number": "530-222-3287",
            "fax_number": "530-222-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "DUSTIN",
        "middle_name": "JAMES",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-09",
        "last_updated": "2023-10-27",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP20860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNP LICENSE",
            "identifier": "NP20860",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.