Individual provider Active NPI

Ernest C Lewis, M.D.

  • Medical Oncology Physician
  • Springfield, MO
National Provider Identifier
1457445579
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
46104 Issued in WI
Practice address
2115 S Fremont Ave
Suite 1000
Springfield, MO 65804-2239
Phone
(417) 820-8099
Fax
(417) 820-8093
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 46104 WI Primary
Medical Oncology Physician 207RX0202X 4301082745 MI
Medical Oncology Physician 207RX0202X 2008020485 MO

Addresses

Primary practice location

2115 S Fremont Ave
Suite 1000
Springfield, MO 65804-2239

Mailing address

PO Box 13453
Green Bay, WI 54307-3453
Phone (920) 432-6049

Other identifiers 5

IdentifierTypeStateIssuer
104541760MedicaidMI
172426001MedicaidAR
34436200MedicaidWI
P00635672OtherMOTRAVELERS RR MEDICARE
EL082745OtherMIBCBS MI

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301082745MIMDMedical Oncology Physician
46104WIMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ozarks Medical Center Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1457445579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13453",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543073453",
            "telephone_number": "920-432-6049",
            "fax_number": "920-884-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S FREMONT AVE",
            "address_2": "SUITE 1000",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042239",
            "telephone_number": "417-820-8099",
            "fax_number": "417-820-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ERNEST",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "WI",
            "license": "46104",
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MI",
            "license": "4301082745",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MO",
            "license": "2008020485",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104541760",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172426001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34436200",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS RR MEDICARE",
            "identifier": "P00635672",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "EL082745",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.