Individual provider Active NPI

Timothy A Lewis, CRNA

  • Certified Registered Nurse Anesthetist
  • Corpus Christi, TX
National Provider Identifier
1306820469
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
714478 Issued in TX
Practice address
600 Elizabeth St
Corpus Christi, TX 78404-2235
Phone
(361) 881-3651
NPI assigned
Dec 2, 2005
Last updated
Oct 26, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 714478 TX Primary

Addresses

Primary practice location

600 Elizabeth St
Corpus Christi, TX 78404-2235

Mailing address

6126 Garden CT
Corpus Christi, TX 78414-6071
Phone (361) 452-0165

Other identifiers 1

IdentifierTypeStateIssuer
85804UOtherTXBCBSTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050308000168 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 9032163662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Associates, IncGroup PAC ID 8325217904, 37 clinicians

Practice addresses (Care Compare)

1011 N Galloway Ave
Mesquite, TX 75149-2433
Phone (800) 875-8523

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
714478TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Anesthesia Consultants LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 16, 2022 Accepting new patients
Gulf Shore Anesthesia Associates PA PastSince Sep 28, 2020 Accepting new patients

Locations

1452 Hughes Rd
Ste 244
Grapevine, TX 76051
Phone (800) 875-8523

8751 Collin McKinney Pkwy
Ste 1603
McKinney, TX 75070

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, 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": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193356800000",
    "number": "1306820469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6126 GARDEN CT",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784146071",
            "telephone_number": "361-452-0165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ELIZABETH ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784042235",
            "telephone_number": "361-881-3651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2007-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "714478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "85804U",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.