Mackenzie Marie Lewis, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

2116 W South 3Rd St
Shelbyville, IL 62565-9102

Phone

(217) 774-2128

NPI assigned

May 15, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1684108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1194416859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 E WERNSING AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624014028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 W SOUTH 3RD ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "625659102",
            "telephone_number": "217-774-2128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1302 Ave Of Mid America",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624014647",
            "country_code": "US",
            "telephone_number": "217-606-3004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MACKENZIE",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-15",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Kirkley, OTR/L
• Jessica Knearem
• Jessie L Knearem, LMT
• Poojitha Kolluri, MD
• Rhonda Marie Kull, D.C.
• Heather Lindahl
• Ashley Elizabeth Lockart, M.S., CCC-SLP
• Joseph T Marcin Jr.
• Rachel Massey, PTA
• Sarah E Massey, APRN, FNP-C

• Physical Therapy Assistant in Shelbyville, IL
• Providers in Shelbyville, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.