Active NPI
Nathan Lewis, DPT
- Physical Therapist
- Medford, OR
National Provider Identifier
1417408055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- T61948
- Practice address
- 14 Cottage St
Medford, OR 97504-7332 - Phone
- (541) 301-2499
- Fax
- (541) 500-3303
- NPI assigned
- Oct 19, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | T61948 | OR | Primary |
Addresses
Primary practice location
14 Cottage St
Medford, OR 97504-7332
Mailing address
945 Oak St
Ashland, OR 97520-1266
Phone (541) 944-7711
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447766027 | Medicaid | OR |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T61948 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609891200000",
"number": "1417408055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "945 OAK ST",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975201266",
"telephone_number": "541-944-7711",
"fax_number": "541-500-3303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 COTTAGE ST",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975047332",
"telephone_number": "541-301-2499",
"fax_number": "541-500-3303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "NATHAN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-19",
"last_updated": "2021-01-06",
"certification_date": "2021-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "T61948",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1447766027",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.