Betsy Jo Lewis

Primary specialty

PharmacistTaxonomy code 183500000X

License

122329 Issued in MN

Practice address

100 Juniper Ave
Wadena, MN 56482-1041

Phone

(218) 849-6414

NPI assigned

Oct 13, 2020

Last updated

Oct 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Walmart Inc.

  dba Walmart Pharmacy 10-4246

  • Community/Retail Pharmacy
  • Wadena, MN
  • NPI 1902961048
  NPD (past)
• Walmart Inc.

  dba Walmart Pharmacy 10-3129

  • Community/Retail Pharmacy
  • Eastvale, CA
  • NPI 1770458945
  NPD (past)

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

{
    "created_epoch": "1602547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1376141242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 JUNIPER AVE",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821041",
            "telephone_number": "218-849-6414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JUNIPER AVE",
            "city": "WADENA",
            "state": "MN",
            "postal_code": "564821041",
            "telephone_number": "218-849-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "BETSY",
        "middle_name": "JO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-13",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MN",
            "license": "122329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "122329",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nyla J Kraemer
• Magaen Kveton, APRN, CNP, FNP-BC
• Leonard Kenneth Lamberty, M.D.
• Kammy Larson
• William Kim Larson, DDS
• Brett Lien, PT, DPT
• John Lindblom, DO
• Megan Elizabeth Lindblom, PHARMD
• Macayla Rose Lindenfelser, NP-C
• Rose Ann Lorentz, A-G NP

• Pharmacist in Wadena, MN
• Providers in Wadena, MN by specialty
• Pharmacist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.