NPIMap

Individual provider Active NPI

Justin J Lewis, PA-C

  • Physician Assistant
  • Salem, KY
National Provider Identifier
1538696356
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2237 Issued in KY
Practice address
141 Hospital Dr
Ste 102
Salem, KY 42078-8043
Phone
(270) 988-3298
Fax
(270) 988-4642
NPI assigned
May 11, 2017
Last updated
Apr 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 PLLCGroup PAC ID 8426965278, 14 clinicians

Practice addresses (Care Compare)

141 Hospital Dr
Suite 102
Salem, KY 42078-8043
Phone (270) 988-3298

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
136934KYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Rivers Healthcare PLLC CurrentSince Jul 16, 2017 Accepting new patients
Tri-Rivers Healthcare PLLC CurrentSince Jul 16, 2017 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

131 Hospital Dr
Salem, KY 42078
Phone (270) 988-2299

141 Hospital Dr
Salem, KY 42078
Phone (270) 988-3298

141 Hospital Dr
Ste 102
Salem, KY 42078
Phone (270) 988-3298

141 Hospital Dr
Ste 103
Salem, KY 42078
Phone (270) 988-3298

Interoperability endpoints

  • Direct secure messaging: justin.lewis.1@17246.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, KY

Sources for this page

Verify at the official NPI Registry.