Organization Active NPI

Michelle M. Lewis, DO., LTD

  • Obstetrics & Gynecology Physician
  • Henderson, NV
National Provider Identifier
1679874648
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
720 Issued in NV
Legal business name
MICHELLE M. LEWIS, DO., LTD
Practice address
1701 N Green Valley Pkwy
Suite 3a
Henderson, NV 89074-5885
Phone
(702) 566-3040
Fax
(702) 361-2813
NPI assigned
Nov 8, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Authorized official

Name
Michelle Lewis, DO
Title
Owner/Physician
Phone
(702) 566-3040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 720 NV Primary

Addresses

Primary practice location

1701 N Green Valley Pkwy
Suite 3a
Henderson, NV 89074-5885

Mailing address

1701 N Green Valley Pkwy
Suite 3a
Henderson, NV 89074-5885
Phone (702) 566-3040

Other identifiers 1

IdentifierTypeStateIssuer
2019372MedicaidNV

National Provider Directory

National Provider Directory

Locations

1701 N Green Valley Pkwy
Ste 3A
Henderson, NV 89074
Phone (702) 566-3040

NPI Registry JSON

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1679874648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 N GREEN VALLEY PKWY",
            "address_2": "SUITE 3A",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745885",
            "telephone_number": "702-566-3040",
            "fax_number": "702-361-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N GREEN VALLEY PKWY",
            "address_2": "SUITE 3A",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890745885",
            "telephone_number": "702-566-3040",
            "fax_number": "702-361-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHELLE M. LEWIS, DO., LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "702-566-3040",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "NV",
            "license": "720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019372",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.