Individual provider Active NPI

Kyle Andrew Lewellen

  • Student in an Organized Health Care Education/Training Program
  • Indianapolis, IN
National Provider Identifier
1326601964
Registry record updated Apr 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
545 Barnhill Dr
Indianapolis, IN 46202-5112
Phone
(317) 274-4966
Fax
(317) 274-8769
NPI assigned
Apr 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

545 Barnhill Dr
Indianapolis, IN 46202-5112

Mailing address

545 Barnhill Dr
Indianapolis, IN 46202-5112
Phone (317) 274-4966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190622000014 IN Order and Referring Only - General SurgeryPractitioner - General Surgery 0547594780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555545600000",
    "number": "1326601964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 BARNHILL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025112",
            "telephone_number": "317-274-4966",
            "fax_number": "317-274-8769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BARNHILL DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025112",
            "telephone_number": "317-274-4966",
            "fax_number": "317-274-8769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWELLEN",
        "first_name": "KYLE",
        "middle_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.