Individual provider Active NPI

Diana Marie Lewis, NP

  • Family Nurse Practitioner
  • Cleveland, TN
National Provider Identifier
1548866866
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28284 Issued in TN
Practice address
2305 Chambliss Ave NW
Cleveland, TN 37311-3847
Phone
(423) 559-6000
NPI assigned
Dec 10, 2020
Last updated
Dec 29, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28284 TN Primary

Addresses

Primary practice location

2305 Chambliss Ave NW
Cleveland, TN 37311-3847

Mailing address

3035 Pin Oaks Cir NE
Cleveland, TN 37323-5251
Phone (423) 584-0236

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address diana.lewis.1@1525.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210302003037 TN Practitioner - Nurse Practitioner 5193131910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Bradley Physician Services, LLCGroup PAC ID 8123563392, 77 clinicians

Practice addresses (Care Compare)

6059 Arbury Way
Suite 100
Ooltewah, TN 37363-5001
Phone (423) 476-4466

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
28284TNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley Physician Services, LLC Family CurrentSince Aug 1, 2024 Accepting new patients

Locations

1060 Peerless Xing NW
Ste 200
Cleveland, TN 37312
Phone (423) 479-4165

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

2700 Westside Dr NW
Ste 204
Cleveland, TN 37312
Phone (423) 476-3711

2800 Westside Dr NW
Cleveland, TN 37312
Phone (423) 339-4100

700 Paul Huff Pkwy NW
Cleveland, TN 37312
Phone (423) 380-6400

6059 Arbury Way
Ste 100
Ooltewah, TN 37363
Phone (423) 476-4466

Interoperability endpoints

  • Direct secure messaging: diana.lewis.1@1525.direct.athenahealth.com
  • Direct secure messaging: diana.lewis.2@31613.direct.athenahealth.com

Organizations & group practices 1

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 1

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": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1548866866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 PIN OAKS CIR NE",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373235251",
            "telephone_number": "423-584-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 CHAMBLISS AVE NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113847",
            "telephone_number": "423-559-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "DIANA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "28284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "diana.lewis.1@1525.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "2305 Chambliss Ave NW",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373113847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.