Active NPI
Justin J Lewis, PA-C
- Physician Assistant
- Salem, KY
National Provider Identifier
1538696356
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2237
- Practice address
- 141 Hospital Dr
Ste 102
Salem, KY 42078-8043 - Phone
- (270) 988-3298
- Fax
- (270) 988-4642
- NPI assigned
- May 11, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 136934 | KY | |
| Physician Assistant | 363A00000X | TC604 | KY | |
| Physician Assistant | 363A00000X | PA2237 | KY | Primary |
Addresses
Primary practice location
141 Hospital Dr
Ste 102
Salem, KY 42078-8043
Mailing address
PO Box 347
Salem, KY 42078-0347
Phone (270) 988-3298
Other practice location 1
308 S Main St
Marion, KY 42064-1545
Phone (270) 965-4377
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000001106789 | Other | KY | ANTHEM BLUE CROSS AND BLUE SHIELD OF KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170825002217 | KY | Practitioner - Physician Assistant | 5991077976 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Tri-Rivers Healthcare PLLC
Practice addresses (Care Compare)
141 Hospital Dr
Suite 102
Salem, KY 42078-8043
Phone (270) 988-3298
Hospital & facility affiliations
- Livingston Hospital and Healthcare Services, Inc
- Crittenden Community Hospital
- Baptist Health Paducah
- Mercy Health - Lourdes Hospital
- Caldwell Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 136934 | KY | MD | Occupational Therapy Assistant |
| PA2237 | KY | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri-Rivers Healthcare PLLC | Current | Accepting new patients | |
| Tri-Rivers Healthcare PLLC | Current | Accepting new patients | |
| Tri-Rivers Healthcare, PLLC | Physician Assistant | Past | Accepting new patients |
Locations
308 S Main St
Marion, KY 42064
Phone (270) 965-4377
141 Hospital Dr
Ste 102
Salem, KY 42078
Phone (270) 988-3298
141 Hospital Dr
Salem, KY 42078
Phone (270) 988-3298
131 Hospital Dr
Salem, KY 42078
Phone (270) 988-2299
141 Hospital Dr
Ste 103
Salem, KY 42078
Phone (270) 988-3298
Interoperability endpoints
- justin.lewis.1@17246.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Rural Health Clinic/Center
- Marion, KY
- NPI 1699895003
-
- Rural Health Clinic/Center
- Salem, KY
- NPI 1588644496
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Salem, KY
- NPI 1588640254
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745539200000",
"number": "1538696356",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 347",
"city": "SALEM",
"state": "KY",
"postal_code": "420780347",
"telephone_number": "270-988-3298",
"fax_number": "270-988-4642"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "141 HOSPITAL DR",
"address_2": "STE 102",
"city": "SALEM",
"state": "KY",
"postal_code": "420788043",
"telephone_number": "270-988-3298",
"fax_number": "270-988-4642"
}
],
"practiceLocations": [
{
"address_1": "308 S Main St",
"address_purpose": "LOCATION",
"city": "Marion",
"state": "KY",
"postal_code": "420641545",
"country_code": "US",
"telephone_number": "270-965-4377",
"fax_number": "270-965-9569",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEWIS",
"first_name": "JUSTIN",
"middle_name": "J",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-11",
"last_updated": "2025-04-25",
"certification_date": "2025-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "KY",
"license": "136934",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "TC604",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "KY",
"license": "PA2237",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS AND BLUE SHIELD OF KY",
"identifier": "000001106789",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, KY
- Lee Ann Grainger Keller, ARNP, RN
- Michael L Keller, R.PH., PHARM.D.
- Knox Chiropractic Center, LLC
- Robert L Knox
- Robin Leidecker, APRN
- Lifeline Homecare of Salem LLC
- Livingston Hospital and Healthcare Services, Inc Cah
- Livingston Hospital and Healthcare Services, Inc.
- Livingston Hospital and Healthcare Services, Inc.
- Livingston Hospital and Healthcare Services, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; 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.
- 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.