Individual provider Active NPI

Kevin Daniel Lewis, D.C.

  • Chiropractor
  • Fairbanks, AK
National Provider Identifier
1497007314
Registry record updated Oct 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
560 Issued in AK
Practice address
308 Old Steese Hwy
Fairbanks, AK 99701-3126
Phone
(503) 724-5579
Fax
(907) 451-7244
NPI assigned
Oct 3, 2012
Last updated
Oct 3, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 560 AK Primary

Addresses

Primary practice location

308 Old Steese Hwy
Fairbanks, AK 99701-3126

Mailing address

308 Old Steese Hwy
Fairbanks, AK 99701-3126
Phone (503) 724-5579

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140829001124 AK Practitioner - Chiropractic 2668690835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arctic Chiropractic Fairbanks LLCGroup PAC ID 0446477665, 4 clinicians

Practice addresses (Care Compare)

308 Old Steese Hwy
Fairbanks, AK 99701-3126
Phone (907) 451-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arctic Chiropractic Fairbanks, LLC Chiropractor CurrentSince May 27, 2014 Accepting new patients

Locations

308 Old Steese Hwy
Fairbanks, AK 99701
Phone (907) 451-7246

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1497007314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 OLD STEESE HWY",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013126",
            "telephone_number": "503-724-5579",
            "fax_number": "907-451-7244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 OLD STEESE HWY",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013126",
            "telephone_number": "503-724-5579",
            "fax_number": "907-451-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KEVIN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.