Active NPI
Tarra J Lewis, APRN
- Family Nurse Practitioner
- Rochester, MN
National Provider Identifier
1629553102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 6123
- Practice address
- 210 9TH St SE
Rochester, MN 55904-6756 - Phone
- (507) 288-3443
- NPI assigned
- Oct 1, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 6123 | MN | Primary |
Addresses
Primary practice location
210 9TH St SE
Rochester, MN 55904-6756
Mailing address
210 9TH St SE
Rochester, MN 55904-6756
Phone (507) 288-3443
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6123 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550793600000",
"number": "1629553102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 9TH ST SE",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559046756",
"telephone_number": "507-288-3443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 9TH ST SE",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559046756",
"telephone_number": "507-288-3443"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "TARRA",
"middle_name": "J",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-01",
"last_updated": "2019-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "6123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.