Individual provider Active NPI

John William Lewis III, FNP-BC

  • Family Nurse Practitioner
  • Oxford, MS
National Provider Identifier
1245959915
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
905535 Issued in MS
Practice address
1487 Belk Blvd
Oxford, MS 38655-5371
Phone
(662) 234-1090
NPI assigned
Aug 25, 2022
Last updated
Aug 25, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 905535 MS Primary

Addresses

Primary practice location

1487 Belk Blvd
Oxford, MS 38655-5371

Mailing address

1487 Belk Blvd
Oxford, MS 38655-5371
Phone (662) 234-1090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231227000565 MS Practitioner - Nurse Practitioner 1557763539 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Clinic of OxfordGroup PAC ID 9537109491, 7 clinicians

Practice addresses (Care Compare)

1487 Belk Blvd
Oxford, MS 38655-5371
Phone 66223410902

960 Avent Dr
Grenada, MS 38901-5230
Phone (662) 227-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Clinic of Oxford CurrentSince Nov 4, 2023 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Feb 3, 2026 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Feb 3, 2026 Accepting new patients

Locations

1300 Sunset Dr
Ste R
Grenada, MS 38901
Phone (662) 226-7540

960 Avent Dr
#J
Grenada, MS 38901
Phone (662) 227-6450

1487 Belk Blvd
Oxford, MS 38655
Phone (601) 234-1090

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IABFAA

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661385600000",
    "number": "1245959915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1487 BELK BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555371",
            "telephone_number": "662-234-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1487 BELK BLVD",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555371",
            "telephone_number": "662-234-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_suffix": "III",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "905535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, MS

Sources for this page

Verify at the official NPI Registry.