Active NPI
Ian Lewis, M.S.
- Speech-Language Pathologist
- Surprise, AZ
National Provider Identifier
1356601157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- TSLP7773
- Practice address
- 16121 N 170TH Ave
Surprise, AZ 85388-1362 - Phone
- (509) 710-3507
- NPI assigned
- May 25, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | TSLP7773 | AZ | Primary |
Addresses
Primary practice location
16121 N 170TH Ave
Surprise, AZ 85388-1362
Mailing address
16121 N 170TH Ave
Surprise, AZ 85388-1362
Phone (509) 710-3507
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TSLP7773 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1337904000000",
"number": "1356601157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16121 N 170TH AVE",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853881362",
"telephone_number": "509-710-3507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16121 N 170TH AVE",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853881362",
"telephone_number": "509-710-3507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "IAN",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-25",
"last_updated": "2012-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "TSLP7773",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.