Individual provider Active NPI

Teresa Lynn Lewis, FNP

  • Nurse Practitioner
  • Lafayette, IN
National Provider Identifier
1477578615
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71001192A Issued in IN
Practice address
2400 Sagamore Pkwy S
Lafayette, IN 47905-5116
Phone
(765) 772-4086
Fax
(765) 772-4086
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71001192A IN Primary
Emergency Medicine Physician 207P00000X 71001192A IN

Addresses

Primary practice location

2400 Sagamore Pkwy S
Lafayette, IN 47905-5116

Mailing address

223 S Brookfield Dr
Lafayette, IN 47905-7223
Phone (765) 426-6339

Other identifiers 1

IdentifierTypeStateIssuer
200880950MedicaidIN

Other names 1

  • Teresa Lynn Gee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20060208000868 IN Practitioner - Nurse Practitioner 7315952504

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71001192AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lafayette Emergency Care, P.C. Emergency Medicine Past Accepting new patients
Decatur Vein Clinic Hobart, PC Past Accepting new patients
Proactive Mso, LLC PastSince Mar 27, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: teresa.gee@446999813881860.direct.elationemr.com

Organizations & group practices 3

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1477578615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 S BROOKFIELD DR",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479057223",
            "telephone_number": "765-426-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 SAGAMORE PKWY S",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055116",
            "telephone_number": "765-772-4086",
            "fax_number": "765-772-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2022-06-06",
        "certification_date": "2022-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001192A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "71001192A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200880950",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "GEE",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.