Individual provider Active NPI

Kiernin A Lewis

  • Occupational Therapist
  • Broken Arrow, OK
National Provider Identifier
1619865524
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
2100 N Aspen Ave
Broken Arrow, OK 74012-1490
Phone
(918) 505-7575
Fax
(918) 505-7375
NPI assigned
Jun 27, 2025
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OK Primary

Addresses

Primary practice location

2100 N Aspen Ave
Broken Arrow, OK 74012-1490

Mailing address

19704 S 43Rd West PL
Mounds, OK 74047-5473
Phone (918) 671-6083

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

Practice roles

OrganizationSpecialtyStatusNew patients
Firefly Pediatric Center, LLC CurrentSince Jun 29, 2025 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1619865524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19704 S 43RD WEST PL",
            "city": "MOUNDS",
            "state": "OK",
            "postal_code": "740475473",
            "telephone_number": "918-671-6083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N ASPEN AVE",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740121490",
            "telephone_number": "918-505-7575",
            "fax_number": "918-505-7375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KIERNIN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.