Active NPI
Phyllis B Lewis, ARNP
- Family Nurse Practitioner
- Jacksonville, FL
National Provider Identifier
1649224023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- ARNP608312
- Practice address
- 5190-9 Timuquana Road
Jacksonville, FL 32210 - Phone
- (904) 253-1120
- Fax
- (904) 253-2514
- NPI assigned
- May 20, 2006
- 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 | ARNP608312 | FL | Primary |
Addresses
Primary practice location
5190-9 Timuquana Road
Jacksonville, FL 32210
Mailing address
900 University Blvd. North
MC 75
Jacksonville, FL 32211
Phone (904) 253-2062
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 034949601 | Medicaid | FL | |
| 0349496-01 | Medicaid | FL |
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
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357084800000",
"number": "1649224023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 UNIVERSITY BLVD. NORTH",
"address_2": "MC 75",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32211",
"telephone_number": "904-253-2062",
"fax_number": "904-253-1942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5190-9 TIMUQUANA ROAD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "32210",
"telephone_number": "904-253-1120",
"fax_number": "904-253-2514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "PHYLLIS",
"middle_name": "B",
"name_prefix": "Ms.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-20",
"last_updated": "2013-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "ARNP608312",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "034949601",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0349496-01",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.