Individual provider Active NPI

Christopher A Lewis, PA-C

  • Physician Assistant
  • Tehachapi, CA
National Provider Identifier
1275781981
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA053552 Issued in PA
Practice address
161 N Mill St
Tehachapi, CA 93561-1347
Phone
(661) 822-9054
Fax
(661) 822-9082
NPI assigned
Sep 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA20021 CA
Physician Assistant 363A00000X 50.002820 OH
Physician Assistant 363A00000X MA053552 PA Primary

Addresses

Primary practice location

161 N Mill St
Tehachapi, CA 93561-1347

Mailing address

659 S. Central Valley Hwy
PO Box 1060
Shafter, CA 93263-1347
Phone (661) 822-9054

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clewis1166209@oc.providencedirect.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141125000623 FL Practitioner - Physician Assistant 9436214715 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA20021CAMDPhysician Assistant
50.002820OHMDPhysician Assistant
MA053552PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Drive Emergency Physicians LLC Past Accepting new patients
Omni Family Health Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: clewis1166209@oc.providencedirect.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618531200000",
    "number": "1275781981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 S. CENTRAL VALLEY HWY",
            "address_2": "PO BOX 1060",
            "city": "SHAFTER",
            "state": "CA",
            "postal_code": "932631347",
            "telephone_number": "661-822-9054",
            "fax_number": "661-822-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 N MILL ST",
            "city": "TEHACHAPI",
            "state": "CA",
            "postal_code": "935611347",
            "telephone_number": "661-822-9054",
            "fax_number": "661-822-9082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "CHRISTOPHER",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-05",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA20021",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.002820",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA053552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clewis1166209@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "331 N Pacific Coast Hwy",
            "city": "El Segundo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902454444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tehachapi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2021; 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.