Active NPI
Zelma Gail Lewis, RECREATION THERAPIST
- Recreation Therapist
- Banning, CA
National Provider Identifier
1225654684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 48594
- Practice address
- 1627 S Hargrave St
Banning, CA 92220-6169 - Phone
- (951) 922-7820
- NPI assigned
- Jun 22, 2020
- Last updated
- Jun 22, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 48594 | NY | Primary |
Addresses
Primary practice location
1627 S Hargrave St
Banning, CA 92220-6169
Mailing address
1627 S Hargrave St
Banning, CA 92220-6169
Phone (951) 922-7820
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48594 | NY | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MH Detention Services | Past | 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.
-
- Community/Behavioral Health Agency
- Banning, CA
- NPI 1184082117
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592784000000",
"number": "1225654684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1627 S HARGRAVE ST",
"city": "BANNING",
"state": "CA",
"postal_code": "922206169",
"telephone_number": "951-922-7820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1627 S HARGRAVE ST",
"city": "BANNING",
"state": "CA",
"postal_code": "922206169",
"telephone_number": "951-922-7820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "ZELMA",
"middle_name": "GAIL",
"credential": "RECREATION THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-22",
"last_updated": "2020-06-22",
"certification_date": "2020-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "NY",
"license": "48594",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Banning, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.