Individual provider Active NPI

Jamesetta Holloway Lewis, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Marion, OH
National Provider Identifier
1689879983
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
34.008866 Issued in OH
Practice address
1040 Delaware Ave
Marion, OH 43302-6416
Phone
(740) 383-7747
Fax
(740) 375-8180
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 34.008866 OH Primary

Addresses

Primary practice location

1040 Delaware Ave
Marion, OH 43302-6416

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other identifiers 1

IdentifierTypeStateIssuer
2766332MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070912000110 OH Practitioner - AnesthesiologyPractitioner - Pain Management 1254424856 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Ohio University, College of Osteopathic Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marion Area Physicians LLCGroup PAC ID 1850549437, 179 clinicians

Practice addresses (Care Compare)

1050 Delaware Ave
Marion, OH 43302-6416
Phone (740) 383-7936

Hospital & facility affiliations

  • Marion General Hospital Hospital, Marion, OH, CCN 360011
  • Ohiohealth Mansfield Hospital Hospital, Mansfield, OH, CCN 360118
  • Grady Memorial Hospital Hospital, Delaware, OH, CCN 360210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.008866OHMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Marion Area Physicians LLC CurrentSince Dec 1, 2023 Accepting new patients
Mercy Professional Care, LLC CurrentSince Jan 4, 2016 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Aultman North Canton Medical Group Past Accepting new patients

Locations

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

1330 Mercy Dr NW
Ste 319
Canton, OH 44708
Phone (330) 580-4706

Dept L3652
Columbus, OH 43260

1050 Delaware Ave
Marion, OH 43302
Phone (740) 383-7038

1040 Delaware Ave
#11
Marion, OH 43302

1040 Delaware Ave
Marion, OH 43302
Phone (330) 256-9874

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1689879983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 DELAWARE AVE",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433026416",
            "telephone_number": "740-383-7747",
            "fax_number": "740-375-8180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JAMESETTA",
        "middle_name": "HOLLOWAY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "OH",
            "license": "34.008866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2766332",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, OH

Sources for this page

Verify at the official NPI Registry.