Individual provider Active NPI

Herbert Anderson Lewis IV, M.D.

  • Family Medicine Physician
  • Russellville, AR
National Provider Identifier
1558657635
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-7839 Issued in AR
Practice address
St Mary'S Hospitalist Group
1808 W Main St
Russellville, AR 72801-2724
Phone
(479) 964-4178
NPI assigned
Jun 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X E-7839 AR
Hospitalist Physician 208M00000X E-7839 AR
Family Medicine Physician 207Q00000X E-7839 AR Primary

Addresses

Primary practice location

St Mary'S Hospitalist Group
1808 W Main St
Russellville, AR 72801-2724

Mailing address

1808 W Main St
Russellville, AR 72801-2724

Other practice location 1

1125 N College Ave
Fayetteville, AR 72703-1908
Phone (479) 521-8260

Other identifiers 1

IdentifierTypeStateIssuer
199346001MedicaidAR

Other names 1

  • Dr. Drew Lewis Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130729000538 AR Practitioner - Family PracticePractitioner - Emergency Medicine 1254572597 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Arkansas College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Northwest Arkansas CommunitiesGroup PAC ID 0648177873, shared by 5 NPIs, 314 clinicians

Practice addresses (Care Compare)

2710 S Rife Medical LN
Rogers, AR 72758-1452
Phone (479) 636-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E-7839ARMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Arkansas Emergency Physicians LLP Emergency Medicine Current Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jul 22, 2024 Accepting new patients
South Arkansas Emergency Physicians, LLP Emergency Medicine CurrentSince Jan 1, 2014 Accepting new patients
Mercy Health Northwest Arkansas Communities Hospitalist CurrentSince Jul 22, 2024 Accepting new patients
Northwest Benton County Physician Services LLC Family Medicine CurrentSince Jul 1, 2014 Accepting new patients
St Mary'S Physician Services LLC CurrentSince Aug 9, 2019 Accepting new patients
South Arkansas Emergency Physicians, LLP Emergency Medicine CurrentSince Jan 1, 2014 Accepting new patients
Mercy Health Northwest Arkansas Communities CurrentSince Jul 22, 2024 Accepting new patients
Mercy Hospital Berryville CurrentSince Sep 15, 2024 Accepting new patients
St Marys Physician Services, LLC CurrentSince Aug 9, 2019 Accepting new patients
Mercy Health Northwest Arkansas Communities Current Accepting new patients
St Marys Physician Services, LLC Past Accepting new patients

Locations

3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100

214 Carter St
Berryville, AR 72616
Phone (870) 423-3355

101 Sun Meadow Dr
Centerton, AR 72719
Phone (479) 273-1426

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

1808 W Main St
Russellville, AR 72801
Phone (479) 964-4178

101 Skyline Dr
Russellville, AR 72801
Phone (479) 968-2345

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

Organizations & group practices 12

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.

Hospital & facility affiliations 3

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1558657635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1808 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012724",
            "fax_number": "479-444-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ST MARY'S HOSPITALIST GROUP",
            "address_2": "1808 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012724",
            "telephone_number": "479-964-4178"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1125 N College Ave",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "AR",
            "postal_code": "727031908",
            "country_code": "US",
            "telephone_number": "479-521-8260",
            "fax_number": "479-444-7820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "HERBERT",
        "middle_name": "ANDERSON",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2021-08-05",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-7839",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AR",
            "license": "E-7839",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-7839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "199346001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DREW",
            "last_name": "LEWIS",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Russellville, AR

Sources for this page

Verify at the official NPI Registry.