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Individual provider Active NPI

Jessica Anne Lewis, FNP-C

  • Family Nurse Practitioner
  • Lewiston, ID
National Provider Identifier
1245098755
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
78877 Issued in ID
Practice address
415 6TH St
Lewiston, ID 83501
Phone
(208) 750-7445
Fax
(208) 750-7395
NPI assigned
Mar 8, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 35472 TN
Family Nurse Practitioner 363LF0000X 78877 ID Primary

Addresses

Primary practice location

415 6TH St
Lewiston, ID 83501

Mailing address

415 6TH Street
Attn: Physician Services
Lewiston, ID 83501-2434
Phone (208) 750-7462

Other practice location 1

31 Reid Hollow Ln Apt F
Jackson, TN 38305-7978
Phone (541) 604-9970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20240618004011 ID Practitioner - Nurse Practitioner 9931642915 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Joseph Hospital LLCGroup PAC ID 8325325806, 91 clinicians

Practice addresses (Care Compare)

415 6TH St
Lewiston, ID 83501-2431
Phone (208) 743-2511

Hospital & facility affiliations

  • St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003
  • Tri-State Memorial Hospital Hospital, Clarkston, WA, CCN 501332
  • Gritman Medical Center Hospital, Moscow, ID, CCN 131327
  • Clearwater Valley Hospital & Clinics Hospital, Orofino, ID, CCN 131320
  • St Mary'S Hospital Hospital, Cottonwood, ID, CCN 131321

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
78877IDMDFamily Nurse Practitioner
35472TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Hospital LLC CurrentSince Aug 1, 2024 Accepting new patients
St. Joseph Hospital LLC Past Accepting new patients

Locations

821 21st Ave
Lewiston, ID 83501
Phone (208) 799-3422

625 6th Ave
Lewiston, ID 83501
Phone (208) 743-8226

415 6th St
Lewiston, ID 83501
Phone (208) 750-7445

307 Saint Johns Way
Ste 1
Lewiston, ID 83501
Phone (208) 743-3998

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: jessica.lewis.1@16883.direct.athenahealth.com

Organizations & group practices 2

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

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1245098755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 6TH STREET",
            "address_2": "ATTN: PHYSICIAN SERVICES",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835012434",
            "telephone_number": "208-750-7462",
            "fax_number": "208-750-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 6TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "83501",
            "telephone_number": "208-750-7445",
            "fax_number": "208-750-7395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 Reid Hollow Ln Apt F",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383057978",
            "country_code": "US",
            "telephone_number": "541-604-9970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JESSICA",
        "middle_name": "ANNE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-08",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "35472",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "78877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.