Individual provider Active NPI

Jessica Maria Lewis, FNP-C

  • Family Medicine Physician
  • New Martinsville, WV
National Provider Identifier
1457873770
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
020906 Issued in OH
Practice address
225 Russell Ave
New Martinsville, WV 26155-1572
Phone
(304) 455-2600
NPI assigned
Jul 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 020906 OH Primary

Addresses

Primary practice location

225 Russell Ave
New Martinsville, WV 26155-1572

Mailing address

49920 State Route 379
Lewisville, OH 43754-9560
Phone (330) 324-3967

Other practice location 1

3194 Core Rd
Parkersburg, WV 26104-1556
Phone (304) 485-5185

Other practice location 2

49920 State Route 379
Lewisville, OH 43754-9560
Phone (740) 838-1572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, OH, NC, OR, WA5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20180327003178 WV Practitioner - Nurse Practitioner 4284996430 Reassigns benefits to 2 organizations
I20221007000281 OH Practitioner - Nurse Practitioner 4284996430 Reassigns benefits to 2 organizations
I20241106000650 NC Practitioner - Nurse Practitioner 4284996430 Reassigns benefits to 1 organization
I20250207002828 OR Practitioner - Nurse Practitioner 4284996430 Reassigns benefits to 1 organization
I20250613001481 WA Practitioner - Nurse Practitioner 4284996430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Boulder Care Provider Group PAGroup PAC ID 6901217447, 115 clinicians

Practice addresses (Care Compare)

106 Langtree Village Dr
Suite 301
Mooresville, NC 28117-7594
Phone (888) 288-4715

111 SW Naito Pkwy
Suite 200
Portland, OR 97204-3512
Phone (503) 563-7370

20046 Walker Rd
Suite 7
Shaker Heights, OH 44122-3645
Phone (503) 208-5061

915 Broadway St
Suite 137
Vancouver, WA 98660-3278
Phone (503) 208-5061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020906OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spero Health of Ohio, LLC CurrentSince May 20, 2022 Accepting new patients
Alignmed Partners, PC CurrentSince Mar 1, 2018 Accepting new patients
Geps Physician Group of West Virginia PC CurrentSince Mar 1, 2018 Accepting new patients
Boulder Care Provider Group PA CurrentSince Aug 1, 2024 Accepting new patients

Locations

1 Emerson Dr
Windsor, CT 06095
Phone (860) 688-6443

106 Langtree Village Dr
Ste 301
Mooresville, NC 28117
Phone (704) 457-1368

1493 S Arlington St
Akron, OH 44306
Phone (234) 274-5827

1750 Southgate Pkwy
Cambridge, OH 43725
Phone (740) 432-3634

20046 Walker Rd
Ste 7
Shaker Heights, OH 44122
Phone (503) 208-5061

111 SW Naito Pkwy
Ste 200
Portland, OR 97204
Phone (503) 208-5061

111 SW Naito Pkwy
Portland, OR 97204
Phone (888) 316-0451

155 Franklin Rd
Ste 430
Brentwood, TN 37027
Phone (615) 265-0359

915 Broadway St
Ste 137
Vancouver, WA 98660
Phone (503) 208-5061

1 Diane Dr
Fort Ashby, WV 26719
Phone (304) 298-3602

101 13th St
Huntington, WV 25701
Phone (304) 525-7622

225 Russell Ave
New Martinsville, WV 26155
Phone (304) 455-2600

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": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1457873770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49920 STATE ROUTE 379",
            "city": "LEWISVILLE",
            "state": "OH",
            "postal_code": "437549560",
            "telephone_number": "330-324-3967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 RUSSELL AVE",
            "city": "NEW MARTINSVILLE",
            "state": "WV",
            "postal_code": "261551572",
            "telephone_number": "304-455-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3194 Core Rd",
            "address_purpose": "LOCATION",
            "city": "Parkersburg",
            "state": "WV",
            "postal_code": "261041556",
            "country_code": "US",
            "telephone_number": "304-485-5185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "49920 State Route 379",
            "address_purpose": "LOCATION",
            "city": "Lewisville",
            "state": "OH",
            "postal_code": "437549560",
            "country_code": "US",
            "telephone_number": "740-838-1572",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JESSICA",
        "middle_name": "MARIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "020906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Martinsville, WV

Sources for this page

Verify at the official NPI Registry.