Active NPI
Jerry Lewis
- Attendant Care Provider
- Clarksville, AR
National Provider Identifier
1194376178
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Attendant Care Provider
- Practice address
- 1606R W Cherry St
Clarksville, AR 72830-2506 - Phone
- (479) 979-4909
- NPI assigned
- Sep 22, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Attendant Care Provider | 3747A0650X | Primary |
Addresses
Primary practice location
1606R W Cherry St
Clarksville, AR 72830-2506
Mailing address
1606R W Cherry St
Clarksville, AR 72830-2506
Phone (479) 979-4909
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572912000000",
"number": "1194376178",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1606R W CHERRY ST",
"city": "CLARKSVILLE",
"state": "AR",
"postal_code": "728302506",
"telephone_number": "479-979-4909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1606R W CHERRY ST",
"city": "CLARKSVILLE",
"state": "AR",
"postal_code": "728302506",
"telephone_number": "479-979-4909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "JERRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-09-22",
"last_updated": "2019-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.