Organization Active NPI

Seth R Lewis MD PC

  • Primary Care Clinic/Center
  • Ogden, UT
National Provider Identifier
1205032190
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SETH R LEWIS MD PC
Practice address
555 E 5300 S Ste 7
Ogden, UT 84405-4509
Phone
(801) 475-5100
Fax
(801) 475-8580
NPI assigned
Jun 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Authorized official

Name
Natalie Hale
Title
Office Manager
Phone
(801) 475-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

555 E 5300 S Ste 7
Ogden, UT 84405-4509

Mailing address

555 E 5300 S Ste 7
Ogden, UT 84405-4509
Phone (801) 475-5100

Other identifiers 5

IdentifierTypeStateIssuer
528641867027MedicaidUT
264301-1205OtherUTSTATE LICENSE NUMBER
F91544OtherUTUPIN
1851409544OtherINDIVIDUAL NPI
000060812OtherPTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070718000021 UT Part B Supplier - Clinic/Group Practice 0143320333 Receives reassigned benefits from 1 practitioner
Practice locations: Ogden, UT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D0973936Seth R Lewis, MD555 East 5300 South, Ste 7, Ogden, UT 84405Certificate of waiverMay 22, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628553600000",
    "number": "1205032190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E 5300 S STE 7",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054509",
            "telephone_number": "801-475-5100",
            "fax_number": "801-475-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E 5300 S STE 7",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844054509",
            "telephone_number": "801-475-5100",
            "fax_number": "801-475-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SETH R LEWIS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-475-5100"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528641867027",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "264301-1205",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "F91544",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1851409544",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "000060812",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.