Mary S Lewis, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

30196 Issued in KY

Practice address

4003 Kresge Way
Suite 410
Louisville, KY 40207-4652

Phone

(502) 893-7462

Fax

(502) 212-7551

NPI assigned

Nov 16, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Medeast Physicians PLLC

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1396948873
  NPD (past)

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1467434365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950122",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950122",
            "telephone_number": "502-893-7462",
            "fax_number": "502-212-7551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4003 KRESGE WAY",
            "address_2": "SUITE 410",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074652",
            "telephone_number": "502-893-7462",
            "fax_number": "502-212-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MARY",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "30196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY STATE LICENSE NUMBER",
            "identifier": "30196",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlewis7715@bhkydirect.com",
            "affiliation": "N",
            "address_1": "4003 Kresge Way",
            "address_2": "Suite 410",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kyra Anne Lewis
• Laura Lewis
• Lauren Lewis, APRN
• Lauren Simel Lewis
• Lydia Joohyn Lewis, DMD
• Miranda Jean Leilani Lewis, APRN
• Norman V Lewis Jr., MD
• Paul Kenneth Lewis, RPH
• Rebecca Laury Lewis, MD
• Richard Lewis, M.D.

• Internal Medicine Physician in Louisville, KY
• Providers in Louisville, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; 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.