Donald R Lewellen, M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

27021 Issued in WI

Practice address

4801 Expo Dr
Manitowoc, WI 54220-9341

Phone

(920) 684-4429

Fax

(920) 684-6892

NPI assigned

Aug 9, 2005

Last updated

Feb 25, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Eye Clinic of Manitowoc, S.C.

  • Ophthalmology Physician
  • Manitowoc, WI
  • NPI 1437144417
  Authorized official Same address or phone
• Two Rivers Eye Clinic

  • Ophthalmology Physician
  • Two Rivers, WI
  • NPI 1114084324
  NPD (past)

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267056000000",
    "number": "1558362046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1900",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542211900",
            "telephone_number": "920-684-4429",
            "fax_number": "920-684-6892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 EXPO DR",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542209341",
            "telephone_number": "920-684-4429",
            "fax_number": "920-684-6892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWELLEN",
        "first_name": "DONALD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2010-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WI",
            "license": "27021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINASTAR FEDERAL",
            "identifier": "037664001",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30675000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Danielle Leggett
• Emily Legreve, M.S., CCC-SLP
• Melissa F Leist, ANP-C
• Maria E Lensmire
• Jane A Lepak Jostsons, MS, LMFT, AAMFT
• Andrew Michael Ley, DPT
• Jessica L Lietzan, FNP-C
• Lighthouse Recovery Community Center Inc
• Patrick Francis Limoni, M.D.
• Elmer L Linboom, M.D.

• Ophthalmology Physician in Manitowoc, WI
• Providers in Manitowoc, WI by specialty
• Ophthalmology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.