Individual provider Active NPI

Karen B Lewis

  • Speech-Language Pathologist
  • Jackson, MS
National Provider Identifier
1255571808
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
S2154 Issued in MS
Practice address
6250 Old Canton Rd Ste 130
Jackson, MS 39211-2946
Phone
(601) 956-7280
Fax
(601) 977-6244
NPI assigned
Feb 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X S2154 MS Primary

Addresses

Primary practice location

6250 Old Canton Rd Ste 130
Jackson, MS 39211-2946

Mailing address

965 Ridge Lake Blvd Ste 103
Memphis, TN 38120-9446
Phone (901) 227-3255

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1255571808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "telephone_number": "901-227-3255",
            "fax_number": "901-227-3205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 OLD CANTON RD STE 130",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392112946",
            "telephone_number": "601-956-7280",
            "fax_number": "601-977-6244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KAREN",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-23",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S2154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; 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.