Samuel Grady Lewis, RTR,RPA,RA,CBRPA

Primary specialty

Radiography Radiologic TechnologistTaxonomy code 2471C3402X

Practice address

308 Fairview Ave
Ponca City, OK 74601-2001

Phone

(580) 765-9588

Fax

(580) 762-1367

NPI assigned

Aug 13, 2007

Last updated

Aug 13, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186963200000",
    "number": "1376735415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 FAIRVIEW AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012001",
            "telephone_number": "580-765-9588",
            "fax_number": "580-762-1367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 FAIRVIEW AVE",
            "city": "PONCA CITY",
            "state": "OK",
            "postal_code": "746012001",
            "telephone_number": "580-765-9588",
            "fax_number": "580-762-1367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SAMUEL",
        "middle_name": "GRADY",
        "name_prefix": "Mr.",
        "credential": "RTR,RPA,RA,CBRPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3402X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Radiography",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Layton
• Bailey Lee
• Carly Lee, RN
• Latasha Leon, LADC-MH
• Kelly Rae Lesley, M.S.
• Taylor Lewis, APRN-CNP
• Summer Dawn Lieb
• Life Vision
• Limb Salvage International (LSI Foot Clinic #1)
• Limb Salvage International (LSI Clinics)

• Radiography Radiologic Technologist in Ponca City, OK
• Providers in Ponca City, OK by specialty
• Radiography Radiologic Technologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.