Individual provider Active NPI

Kenan Lewis

  • Occupational Therapist
  • Smithfield, NC
National Provider Identifier
1376305243
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
16263 Issued in NC
Practice address
101 E Market St Ste 3B
Smithfield, NC 27577-3981
Phone
(919) 912-2030
NPI assigned
Jan 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 16263 NC Primary

Addresses

Primary practice location

101 E Market St Ste 3B
Smithfield, NC 27577-3981

Mailing address

39 Wood Stork CT
Clayton, NC 27520-4178
Phone (919) 912-2030

Other practice location 1

11183 US Hwy. 70 Business
Clayton, NC 27520-2752
Phone (919) 912-2030

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

State licenses

LicenseStateTypeSpecialty
16263NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Abil-OT Occupational Therapist CurrentSince Jan 1, 2024 Accepting new patients

Locations

11183 US Highway 70 Bus W
Clayton, NC 27520
Phone (919) 243-2201

101 E Market St
Ste 3B
Smithfield, NC 27577
Phone (919) 243-2201

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1706227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1376305243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WOOD STORK CT",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204178",
            "telephone_number": "919-912-2030",
            "fax_number": "919-585-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MARKET ST STE 3B",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275773981",
            "telephone_number": "919-912-2030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11183 US Hwy. 70 Business",
            "address_purpose": "LOCATION",
            "city": "Clayton",
            "state": "NC",
            "postal_code": "275202752",
            "country_code": "US",
            "telephone_number": "919-912-2030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KENAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-26",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "16263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.