Roger a Lewis

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12705 Issued in WV

Legal business name

ROGER A LEWIS

Doing business as

Cranberry Medical Clinic

Practice address

603B W State Ave
Terra Alta, WV 26764-1223

Phone

(304) 789-2457

Fax

(304) 789-6812

NPI assigned

Mar 20, 2007

Last updated

Feb 8, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Norma Keim

Title

Office Manager

Phone

(304) 789-2457

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cranberry Medical Clinic Doing business as

Locations

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1508981291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603B W STATE AVE",
            "city": "TERRA ALTA",
            "state": "WV",
            "postal_code": "267641223",
            "telephone_number": "304-789-2457",
            "fax_number": "304-789-6812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603B W STATE AVE",
            "city": "TERRA ALTA",
            "state": "WV",
            "postal_code": "267641223",
            "telephone_number": "304-789-2457",
            "fax_number": "304-789-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER A LEWIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2010-02-08",
        "status": "A",
        "authorized_official_last_name": "KEIM",
        "authorized_official_first_name": "NORMA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-789-2457"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "12705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0201807000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CM7276",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cranberry Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rem West Virginia, LLC
• Rescare
• Sara Ann Roberts
• Crystal Lynn Rocha
• Heather Marie Rodeheaver, LMT
• Gail Rose
• Heather Raynae Rosenberger
• Rylee Roy
• Lisa Ryan, PSYD
• Carla Denell Seigh

• Family Medicine Physician in Terra Alta, WV
• Providers in Terra Alta, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2010; 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.