Organization Active NPI

Johnathan Lewis MD PLLC

Doing business as The Lewis Clinic

  • Family Medicine Physician
  • Camden, AR
National Provider Identifier
1265047187
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
JOHNATHAN LEWIS MD PLLC
Doing business as
The Lewis Clinic
Practice address
430 Magnolia Rd
Camden, AR 71701-4146
Phone
(870) 836-5709
Fax
(870) 836-5837
NPI assigned
Sep 9, 2020
Last updated
Aug 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Johnathan Lewis, MDNPI 1699741298
Title
Owner
Phone
(870) 836-5709

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

430 Magnolia Rd
Camden, AR 71701-4146

Mailing address

430 Magnolia Rd
Camden, AR 71701-4146
Phone (870) 836-5709

Other names 1

  • The Lewis Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200923000480 AR Part B Supplier - Clinic/Group Practice 2668891763 Receives reassigned benefits from 4 practitioners
Practice locations: Camden, AR

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
04D2194593Lewis Clinic, the430 Magnolia Road, Camden, AR 71701Certificate of waiverSep 30, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1265047187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MAGNOLIA RD",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717014146",
            "telephone_number": "870-836-5709",
            "fax_number": "870-837-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MAGNOLIA RD",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717014146",
            "telephone_number": "870-836-5709",
            "fax_number": "870-836-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNATHAN LEWIS MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-09",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JOHNATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-836-5709",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Lewis Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Lewis Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camden, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.