Active NPI
Fredrick Austin Lewis, MD
- Diagnostic Radiology Physician
- Hammond, LA
National Provider Identifier
1629299730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 010125
- Practice address
- 22 Pin Oak LN
Hammond, LA 70401-8201 - Phone
- (985) 429-8412
- NPI assigned
- May 2, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 010125 | LA | Primary |
Addresses
Primary practice location
22 Pin Oak LN
Hammond, LA 70401-8201
Mailing address
22 Pin Oak LN
Hammond, LA 70401-8201
Phone (985) 429-8412
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1110124 | Medicaid | LA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010125 | LA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629299730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 PIN OAK LN",
"city": "HAMMOND",
"state": "LA",
"postal_code": "704018201",
"telephone_number": "985-429-8412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 PIN OAK LN",
"city": "HAMMOND",
"state": "LA",
"postal_code": "704018201",
"telephone_number": "985-429-8412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "FREDRICK",
"middle_name": "AUSTIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "LA",
"license": "010125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1110124",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hammond, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.