Organization Active NPI

Lewis Primary Care, P.a.

  • Medical Physician Assistant
  • Salisbury, MD
National Provider Identifier
1639619224
Registry record updated Apr 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Legal business name
LEWIS PRIMARY CARE, P.A.
Practice address
1324 Belmont Ave
Unit 103
Salisbury, MD 21804-4584
Phone
(443) 978-7383
Fax
(443) 978-7598
NPI assigned
Mar 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2017

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

Authorized official

Name
Mr. Vincent Walter Lewis, PA-CNPI 1275791147
Title
Owner
Phone
(443) 978-7383

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X Primary

Addresses

Primary practice location

1324 Belmont Ave
Unit 103
Salisbury, MD 21804-4584

Mailing address

1324 Belmont Ave
Unit 103
Salisbury, MD 21804-4584
Phone (443) 978-7383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170720000130 MD Part B Supplier - Clinic/Group Practice 2365712619 Receives reassigned benefits from 1 practitioner
Practice locations: Salisbury, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2129923Lewis Primary Care, PA1324 Belmont Ave Unit 103, Salisbury, MD 21804Certificate of waiverApr 27, 2027

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GIAJAD

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493510400000",
    "number": "1639619224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 BELMONT AVE",
            "address_2": "UNIT 103",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218044584",
            "telephone_number": "443-978-7383",
            "fax_number": "443-978-7598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 BELMONT AVE",
            "address_2": "UNIT 103",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218044584",
            "telephone_number": "443-978-7383",
            "fax_number": "443-978-7598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS PRIMARY CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-04-30",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-978-7383",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.