Individual provider Active NPI

Jennifer Rosann Lewis, CNA

  • Nurse's Aide
  • Winnemucca, NV
National Provider Identifier
1689130403
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
CNA032875 Issued in NV
Practice address
118 E Haskell St
Winnemucca, NV 89445-3247
Phone
(775) 623-5222
NPI assigned
Feb 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 821055 NV
Nurse's Aide 376K00000X CNA032875 NV Primary

Addresses

Primary practice location

118 E Haskell St
Winnemucca, NV 89445-3247

Mailing address

8650 Memory LN
Winnemucca, NV 89445-6661
Phone (775) 403-3247

Other identifiers 2

IdentifierTypeStateIssuer
821055OtherNVSTATE BOARD OF NURSING NEVADA REGISTERED NURSE
CNA032875OtherNVSTATE BOARD OF NURSING

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

State licenses

LicenseStateTypeSpecialty
821055NVMDMedical-Surgical Registered Nurse
CNA032875NVMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1550361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1689130403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8650 MEMORY LN",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894456661",
            "telephone_number": "775-403-3247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E HASKELL ST",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894453247",
            "telephone_number": "775-623-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JENNIFER",
        "middle_name": "ROSANN",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-17",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "NV",
            "license": "821055",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NV",
            "license": "CNA032875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF NURSING NEVADA REGISTERED NURSE",
            "identifier": "821055",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF NURSING",
            "identifier": "CNA032875",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnemucca, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.