Individual provider Active NPI

John Marshall Lewis, D.O.

  • Internal Medicine Physician
  • Crossville, TN
National Provider Identifier
1336432798
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO02570 Issued in TN
Practice address
100 Lantana Rd Ste 202
Crossville, TN 38555
Phone
(931) 484-5141
Fax
(931) 484-5620
NPI assigned
May 18, 2011
Last updated
Apr 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X DO02570 TN Primary

Addresses

Primary practice location

100 Lantana Rd Ste 202
Crossville, TN 38555

Mailing address

100 Lantana Rd Ste 202
Crossville, TN 38555-1903
Phone (931) 484-5141

Other practice location 1

229 Interstate Dr
Suite 103
Crossville, TN 38555-2709
Phone (931) 210-5577

Other identifiers 1

IdentifierTypeStateIssuer
Q006079MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lewis.john.m@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20140626000385 TN Practitioner - Internal Medicine 8729224431 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lincoln Memorial University Medical Department, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

100 Lantana Rd
Suite 202
Crossville, TN 38555-1903
Phone (931) 484-5141

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.49 of 100Reported as individual
Quality
84.53
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO02570TNMDInternal Medicine Physician
2570TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Services of Tennessee PC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Covenant Medical Group, Inc CurrentSince Jul 1, 2018 Accepting new patients
Covenant Medical Group, Inc. Internal Medicine CurrentSince Jul 1, 2018 Accepting new patients
Exac Care, PLLC CurrentSince Jul 1, 2014 Accepting new patients

Locations

229 Interstate Dr
Ste 103
Crossville, TN 38555
Phone (931) 210-5577

421 S Main St
Crossville, TN 38555
Phone (931) 260-1465

100 Lantana Rd
Ste 202
Crossville, TN 38555
Phone (931) 484-5141

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

Organizations & group practices 4

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1336432798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LANTANA RD STE 202",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385551903",
            "telephone_number": "931-484-5141",
            "fax_number": "931-484-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LANTANA RD STE 202",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "38555",
            "telephone_number": "931-484-5141",
            "fax_number": "931-484-5620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "229 Interstate Dr",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Crossville",
            "state": "TN",
            "postal_code": "385552709",
            "country_code": "US",
            "telephone_number": "931-210-5577",
            "fax_number": "931-210-5575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JOHN",
        "middle_name": "MARSHALL",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-18",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "DO02570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q006079",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lewis.john.m@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Lantana Rd Ste 202",
            "city": "Crossville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "38555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

Verify at the official NPI Registry.