Individual provider Active NPI

Jeffrey E. Lewis, D.C.

  • Chiropractor
  • Magnolia, AR
National Provider Identifier
1396743845
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1645 Issued in AR
Practice address
212 South Washington
Magnolia, AR 71753-2669
Phone
(870) 235-3100
Fax
(870) 235-3101
NPI assigned
Jul 8, 2005
Last updated
Sep 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1645 AR Primary

Addresses

Primary practice location

212 South Washington
Magnolia, AR 71753-2669

Mailing address

212 South Washington
Magnolia, AR 71753-2669
Phone (870) 235-3100

Other identifiers 2

IdentifierTypeStateIssuer
5Y424OtherARBCBS PIN
158872718MedicaidAR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050804000891 AR Practitioner - Chiropractic 8224067707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

212 S Washington
Magnolia, AR 71753-3921

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffery E. Lewis, D.C. Chiropractor CurrentSince Jun 1, 2008 Accepting new patients

Locations

212 S Washington
Magnolia, AR 71753
Phone (870) 235-3100

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1396743845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 SOUTH WASHINGTON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532669",
            "telephone_number": "870-235-3100",
            "fax_number": "870-235-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 SOUTH WASHINGTON",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717532669",
            "telephone_number": "870-235-3100",
            "fax_number": "870-235-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JEFFREY",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "1645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "5Y424",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158872718",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Magnolia, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.