Kenneth C. Lewis MD,LLC

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

KENNETH C. LEWIS MD,LLC

Practice address

2460 Patterson Rd Unit 4
Grand Junction, CO 81505-1027

Phone

(970) 254-1686

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Kenneth Lewis, MDNPI 1285776864

Title

Owner

Phone

(970) 254-1686

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Tax ID family

Kenneth C Lewis MD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Kenneth C. Lewis MD,LLC

  • Pain Medicine (Anesthesiology) Physician
  • Grand Junction, CO
  • NPI 1912639642
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth C Lewis, MD

  • Pain Medicine (Anesthesiology) Physician
  • Grand Junction, CO
  • NPI 1285776864
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1275675860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4433",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815024433",
            "telephone_number": "970-254-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 PATTERSON RD UNIT 4",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051027",
            "telephone_number": "970-254-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH C. LEWIS MD,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-254-1686",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DC6242",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09702377",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glenn Ross Kempeers, MD
• Barbara L Kennedy, LCSW
• James Michael Kennedy, D.D.S.
• Jennifer Elizabeth Kennedy, MD
• Mark Allen Kennedy
• Kenneth C. Lewis MD,LLC
• Kelsey Lee Kerton, D.O.
• Bradley Robert Kessler
• Ketamine Infusion Specialists
• Ketamine West LLC

• Pain Medicine (Anesthesiology) Physician in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Pain Medicine (Anesthesiology) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.