Organization Active NPI

Jawaun Michael Lewis DO PC

  • Neurology Physician
  • Norman, OK
National Provider Identifier
1356501019
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
4092 Issued in OK
Legal business name
JAWAUN MICHAEL LEWIS DO PC
Practice address
3280 Marshall Avenue
Norman, OK 73072-8028
Phone
(405) 579-5858
Fax
(405) 292-1787
NPI assigned
Jun 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Authorized official

Name
Mr. Jawaun Michael Lewis, DONPI 1922150531
Title
Owner
Phone
(405) 579-5858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X 4092 OK Primary

Addresses

Primary practice location

3280 Marshall Avenue
Norman, OK 73072-8028

Mailing address

3280 Marshall Avenue
Norman, OK 73072-8028
Phone (405) 579-5858

Other identifiers 1

IdentifierTypeStateIssuer
200034410BMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090831000202 OK Part B Supplier - Clinic/Group Practice 1052466828 Receives reassigned benefits from 1 practitioner
Practice locations: Boley, OK; Tulsa, OK

National Provider Directory

National Provider Directory

Locations

3325 French Park Dr
Edmond, OK 73034

7122 S Sheridan Rd
Tulsa, OK 74133
Phone (405) 541-1146

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285632000000",
    "number": "1356501019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3280 MARSHALL AVENUE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730728028",
            "telephone_number": "405-579-5858",
            "fax_number": "405-292-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3280 MARSHALL AVENUE",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730728028",
            "telephone_number": "405-579-5858",
            "fax_number": "405-292-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAWAUN MICHAEL LEWIS DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2010-09-28",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JAWAUN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-579-5858",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OK",
            "license": "4092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034410B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.