Wendell R Lewis Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

01323 Issued in WV

Practice address

45 Hunt Club Dr
Ridgeley, WV 26753-7567

Phone

(304) 726-4501

Fax

(304) 726-4051

NPI assigned

Aug 17, 2007

Last updated

Jul 13, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in PA, MD2 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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ahn Emergency Group of Pittsburgh LTD.

  • Emergency Medicine Physician
  • Pittsburgh, PA
  • NPI 1043635402
  Medicare reassignment
• Mep Health, LLC

  • Emergency Medicine Physician
  • Rockville, MD
  • NPI 1164483558
  Medicare reassignment
• Upmc Western Maryland Corporation

  dba UPMC Western Maryland

  • Internal Medicine Physician
  • Cumberland, MD
  • NPI 1184769952
  Medicare reassignment
• Upmc Western Maryland Health Services, LLC

  • Internal Medicine Physician
  • Cumberland, MD
  • NPI 1447976584
  Medicare reassignment
• Upmc Western Maryland Corporation

  dba UPMC Western Maryland

  • Clinic/Center
  • Cumberland, MD
  • NPI 1780251850
  NPD
• Upmc Western Maryland Health Services, LLC

  • Internal Medicine Physician
  • Cumberland, MD
  • NPI 1134844764
  NPD
• Upmc Western Maryland Health Services, LLC

  • Cardiovascular Disease Physician
  • Westernport, MD
  • NPI 1487468112
  NPD
• Ecs of Virginia, Inc.

  • Emergency Medicine Physician
  • Emporia, VA
  • NPI 1821083874
  NPD (past)
• Sterling Emergency Services of Virginia Inc

  • Emergency Medicine Physician
  • Farmville, VA
  • NPI 1649265604
  NPD (past)
• Upmc Western Maryland Corporation

  dba UPMC Western Maryland

  • Psychiatry Physician
  • Cumberland, MD
  • NPI 1285779884
  NPD (past)

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

{
    "created_epoch": "1187308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1508058009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 J D ANDERSON DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053494",
            "telephone_number": "304-598-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 HUNT CLUB DR",
            "city": "RIDGELEY",
            "state": "WV",
            "postal_code": "267537567",
            "telephone_number": "304-726-4501",
            "fax_number": "304-726-4051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "23789 Garrett Hwy",
            "address_purpose": "LOCATION",
            "city": "Mc Henry",
            "state": "MD",
            "postal_code": "215411338",
            "country_code": "US",
            "telephone_number": "240-488-4139",
            "fax_number": "240-488-4956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 W Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "MD",
            "postal_code": "215024331",
            "country_code": "US",
            "telephone_number": "240-964-9300",
            "fax_number": "240-964-9310",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10701 New Georges Creek Rd SW",
            "address_purpose": "LOCATION",
            "city": "Frostburg",
            "state": "MD",
            "postal_code": "215321457",
            "country_code": "US",
            "telephone_number": "301-689-3229",
            "fax_number": "301-689-1129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 J D Anderson Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265053494",
            "country_code": "US",
            "telephone_number": "304-598-1200 x1460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "WENDELL",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-17",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "WV",
            "license": "01323",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C05465",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "01323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA PA LICENSE",
            "identifier": "MA053081",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0110002558",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEST VIRGINIA LICENSE",
            "identifier": "01323",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Hunt
• Susan Violet Johnson
• Jane E Karr, C.R.N.F.A.
• Leah Marie Lambka, P.T.A
• Amealea Leath
• Courtney Renee Liller
• Margaret E Lindner
• Cathy Sue Longerbeam
• Tamarah Lynn Lottmann
• Rebekah Lynn Louk

• Physician Assistant in Ridgeley, WV
• Providers in Ridgeley, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.