Individual provider Active NPI

Michael Jeff Lewis, CRNA

  • Certified Registered Nurse Anesthetist
  • Shreveport, LA
National Provider Identifier
1366773400
Registry record updated Jan 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
TAP002239 Issued in LA
Practice address
905 Crescent Rd
Shreveport, LA 71107-3908
Phone
(318) 617-5563
NPI assigned
Jan 28, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X TAP002239 LA Primary

Addresses

Primary practice location

905 Crescent Rd
Shreveport, LA 71107-3908

Mailing address

PO Box 1350
Minden, LA 71058-1350
Phone (318) 617-5563

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110210001012 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941480719 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Willis Knighton Medical Center Inc Crna GroupGroup PAC ID 1759358674, 93 clinicians

Practice addresses (Care Compare)

8001 Youree Dr
Shreveport, LA 71115-2302
Phone (318) 212-3000

Hospital & facility affiliations

  • Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
TAP002239LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Willis Knighton Medical Center Inc. Crna Group Nurse Anesthetist, Certified Registered CurrentSince Jun 5, 2017 Accepting new patients
Anesthesia Dynamics LLC Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2022 Accepting new patients
Medical Center Anesthesiologists CurrentSince Mar 1, 2015 Accepting new patients
Homer Memorial Hospital CurrentSince Jul 10, 2011 Accepting new patients
Homer Memorial Hospital Nurse Anesthetist, Certified Registered CurrentSince Jul 10, 2011 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice CurrentSince Mar 10, 2020 Accepting new patients
Tandem Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Oct 20, 2014 Accepting new patients
University Health Shreveport LLC CurrentSince Oct 16, 2018 Accepting new patients
Webster Anesthesiology Associates, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Med-Trans Corporation Past Accepting new patients

Locations

3220 N St NW
Washington, DC 20007
Phone (202) 338-6051

620 E College St
Homer, LA 71040
Phone (318) 927-2024

207 Jefferson St
Mansfield, LA 71052
Phone (318) 871-3109

1512 W Kirby Pl
Shreveport, LA 71103
Phone (318) 626-0177

445 Ashley Ridge Blvd
Shreveport, LA 71106
Phone (318) 869-1130

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

8001 Youree Dr
Shreveport, LA 71115
Phone (318) 212-3000

1500 Line Ave
Shreveport, LA 71101
Phone (318) 213-3754

3217 Mabel St
Shreveport, LA 71103

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

1455 E Bert Kouns Industrial Loop
Shreveport, LA 71105
Phone (318) 300-3643

Organizations & group practices 10

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.

Hospital & facility affiliations 4

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": "1264636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264636800000",
    "number": "1366773400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1350",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710581350",
            "telephone_number": "318-617-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 CRESCENT RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711073908",
            "telephone_number": "318-617-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MICHAEL",
        "middle_name": "JEFF",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-28",
        "last_updated": "2010-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "TAP002239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

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