Lisa E Lewis, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

K0730 Issued in TX

Practice address

6618 Fossil Bluff Dr
Ste 116
Fort Worth, TX 76137-7533

Phone

(817) 847-6420

Fax

(817) 847-6412

NPI assigned

Oct 10, 2006

Last updated

Mar 31, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Lisa Ehl Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: lisa.lewis.1@23838.direct.athenahealth.com

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.

• Omar a. Gomez, M.D.,P.a.

  dba Kid Care Pediatrics

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1164541967
  NPD (past)
• Omar a. Gomez, M.D.,P.a.

  dba Kid Care Pediatrics

  • Pediatrics Physician
  • Keller, TX
  • NPI 1710006598
  NPD (past)
• Rencare Inc

  dba Gateway Dialysis Facility

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Antonio, TX
  • NPI 1205895620
  NPD (past)
• Usrc Sa Pleasanton Road LLC

  dba US Renal Care Pleasanton Road Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Antonio, TX
  • NPI 1932168374
  NPD (past)

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238457600000",
    "number": "1285722983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N RUFE SNOW DR",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762484226",
            "telephone_number": "817-337-5503",
            "fax_number": "817-337-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6618 FOSSIL BLUFF DR",
            "address_2": "STE 116",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761377533",
            "telephone_number": "817-847-6420",
            "fax_number": "817-847-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "LISA",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2009-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K0730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KELLER GROUP NPI",
            "identifier": "1710006598",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8K6666",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FORT WORTH GROUP NPI",
            "identifier": "1164541967",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0046KV",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "047946102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "EHL",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Lewis, LPC-S
• Kasey Ann Lewis, RD LD
• Katherine Audrey Lewis, LPA
• Kendall Lewis, MD
• Kyle Brent Lewis, MD
• Madison Lewis, DPT
• Matthew Edward Lewis, DMD
• Rand H. Lewis, D.C.
• Sara Christine Lewis, OTR/L
• Stacey Lynn Lewis, LCSW

• Pediatrics Physician in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.