Individual provider Active NPI

Michael Shannon Lewis, NP-C

  • Adult Health Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1396070769
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
A0909042 Issued in OH
Practice address
170 Taylor Station Rd
Columbus, OH 43213-4441
Phone
(614) 851-7551
NPI assigned
Oct 2, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X A0909042 OH Primary

Addresses

Primary practice location

170 Taylor Station Rd
Columbus, OH 43213-4441

Mailing address

3583 Ziner CT
Grove City, OH 43123-4815
Phone (614) 394-4969

Other identifiers 1

IdentifierTypeStateIssuer
0059811MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091117000711 OH Practitioner - Nurse Practitioner 4688712359 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.04 of 100Reported as group
Quality
58.67
Promoting interoperability
98
Improvement activities
40
Cost
76.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A0909042OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
At Your Door Visiting Healthcare Services, LLC CurrentSince Mar 15, 2022 Accepting new patients
Ohiohealth Corporation CurrentSince May 1, 2023 Accepting new patients
Ohiohealth Corporation CurrentSince May 1, 2023 Accepting new patients
Health First Medical Center PastSince Mar 20, 2019 Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

7500 Hospital Dr
Dublin, OH 43016
Phone (614) 544-8000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26301/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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": "1254441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1396070769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3583 ZINER CT",
            "city": "GROVE CITY",
            "state": "OH",
            "postal_code": "431234815",
            "telephone_number": "614-394-4969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 TAYLOR STATION RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432134441",
            "telephone_number": "614-851-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MICHAEL",
        "middle_name": "SHANNON",
        "name_prefix": "Mr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-02",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "A0909042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0059811",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.