Active NPI
Amy Lewis, PHD
- Clinical Psychologist
- Fulton, MO
National Provider Identifier
1275249153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2022047344
- Practice address
- 600 E 5TH St
Fulton, MO 65251-1753 - Phone
- (573) 592-2030
- NPI assigned
- Jan 25, 2023
- Last updated
- Jan 25, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2022047344 | MO | Primary |
Addresses
Primary practice location
600 E 5TH St
Fulton, MO 65251-1753
Mailing address
600 E 5TH St
Fulton, MO 65251-1753
Phone (573) 592-2030
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- University of Mississippi School of Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
600 E 5TH St
Fulton State Hospital
Fulton, MO 65251-1793
Phone (573) 592-4100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674604800000",
"number": "1275249153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 E 5TH ST",
"city": "FULTON",
"state": "MO",
"postal_code": "652511753",
"telephone_number": "573-592-2030"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 E 5TH ST",
"city": "FULTON",
"state": "MO",
"postal_code": "652511753",
"telephone_number": "573-592-2030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "AMY",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-25",
"last_updated": "2023-01-25",
"certification_date": "2023-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "2022047344",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fulton, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.