Individual provider Active NPI

Katherine J Lewis, MD

  • Pediatrics Physician
  • Tampa, FL
National Provider Identifier
1396761219
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME43232 Issued in FL
Practice address
3222 W Azeele St
Tampa, FL 33609-3280
Phone
(813) 872-8491
Fax
(813) 872-7766
NPI assigned
Jul 14, 2006
Last updated
Dec 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME43232 FL Primary

Addresses

Primary practice location

3222 W Azeele St
Tampa, FL 33609-3280

Mailing address

4033 Tampa Rd
Ste. 101
Oldsmar, FL 34677-3224
Phone (813) 854-2003

Other identifiers 1

IdentifierTypeStateIssuer
069691900MedicaidFL

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME43232FLMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Health Care Alliance, PA Pediatrics PastSince Aug 28, 2021 Accepting new patients
Pediatric Health Care Alliance, PA Pediatrics Past Accepting new patients

Organizations & group practices 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1396761219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 TAMPA RD",
            "address_2": "STE. 101",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346773224",
            "telephone_number": "813-854-2003",
            "fax_number": "813-855-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3222 W AZEELE ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093280",
            "telephone_number": "813-872-8491",
            "fax_number": "813-872-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KATHERINE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME43232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069691900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; 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.