Active NPI
Jaelynn Lewis
- Registered Nurse
- Ferndale, MI
National Provider Identifier
1558148155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704363465
- Practice address
- 911 E 9 Mile Rd
Ferndale, MI 48220-1934 - Phone
- (248) 336-4000
- Fax
- (248) 581-8839
- NPI assigned
- Sep 8, 2023
- Last updated
- Sep 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704363465 | MI | Primary |
Addresses
Primary practice location
911 E 9 Mile Rd
Ferndale, MI 48220-1934
Mailing address
18000 W 9 Mile Rd Ste 200
Southfield, MI 48075-4020
Phone (248) 336-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704363465 | MI | MD | Registered Nurse |
Interoperability endpoints
- jlewis1665556@epic00.shdirect.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694131200000",
"number": "1558148155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18000 W 9 MILE RD STE 200",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754020",
"telephone_number": "248-336-4000",
"fax_number": "248-581-8839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 E 9 MILE RD",
"city": "FERNDALE",
"state": "MI",
"postal_code": "482201934",
"telephone_number": "248-336-4000",
"fax_number": "248-581-8839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "JAELYNN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-08",
"last_updated": "2023-09-08",
"certification_date": "2023-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704363465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ferndale, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.