Active NPI
Kellie Ann Lewis, DPT
- Physical Therapist
- Albany, OR
National Provider Identifier
1497194245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 60199
- Practice address
- 400 Hickory St NW Ste 201
Albany, OR 97321-1700 - Phone
- (541) 812-5840
- NPI assigned
- Jun 14, 2013
- Last updated
- Sep 22, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 60199 | OR | Primary |
Addresses
Primary practice location
400 Hickory St NW Ste 201
Albany, OR 97321-1700
Mailing address
PO Box 1188
Corvallis, OR 97339-1188
Other practice location 1
930 SW Abbey Street
SPCH
Newport, OR 97365
Phone (541) 574-4731
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60199 | Other | OR | LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | klewis95685@samhealth.direct-ci.com |
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
Interoperability endpoints
- klewis95685@samhealth.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632268800000",
"number": "1497194245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1188",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973391188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 HICKORY ST NW STE 201",
"city": "ALBANY",
"state": "OR",
"postal_code": "973211700",
"telephone_number": "541-812-5840"
}
],
"practiceLocations": [
{
"address_1": "930 SW Abbey Street",
"address_2": "SPCH",
"address_purpose": "LOCATION",
"city": "Newport",
"state": "OR",
"postal_code": "97365",
"country_code": "US",
"telephone_number": "541-574-4731",
"fax_number": "541-574-4998",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEWIS",
"first_name": "KELLIE",
"middle_name": "ANN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-14",
"last_updated": "2021-09-22",
"certification_date": "2021-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "60199",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "60199",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "klewis95685@samhealth.direct-ci.com",
"affiliation": "N",
"address_1": "400 Hickory St NW Ste 201",
"city": "Albany",
"state": "OR",
"country_code": "US",
"postal_code": "973211700",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Albany, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.