Brant Walter Lewis, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1870 Issued in OR

Practice address

14851 SE 82ND Dr
Clackamas, OR 97015-7624

Phone

(503) 656-0139

Fax

(503) 557-4871

NPI assigned

Nov 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clackamas Physical Therapy Associates, Inc.Group PAC ID 1557407012, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Clackamas Physical Therapy Associates, Inc.

  • Physical Therapy Clinic/Center
  • Clackamas, OR
  • NPI 1548443955
  Medicare reassignment Care Compare group NPD
• Physical Therapy Associates of Camas

  • Physical Therapy Clinic/Center
  • Camas, WA
  • NPI 1154574614
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306911300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14851 SE 82ND DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970157624",
            "telephone_number": "503-656-0139",
            "fax_number": "503-557-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14851 SE 82ND DR",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970157624",
            "telephone_number": "503-656-0139",
            "fax_number": "503-557-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "BRANT",
        "middle_name": "WALTER",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "1870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007646",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mai P Leopold, DO
• Dillon Lesieur
• Tracey Beth Leslie, MSPT
• Nancy M Leung
• Matthew Levy
• Gerald Rex Lewis, RN
• Linda Murrish Lewis, MD
• Larry Victor Lewman, M.D.
• Alvin Yichieh Li, MD
• Lin Juan Li, PA-C

• Physical Therapist in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.