Active NPI
Gary William Lewis, PT
- Physical Therapist
- Orange Park, FL
National Provider Identifier
1689913188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 1839
- Practice address
- 1215 Kingsley Ave
Orange Park, FL 32073-4631 - Phone
- (904) 269-8922
- NPI assigned
- Feb 5, 2013
- Last updated
- Feb 5, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT 1839 | FL | Primary |
Addresses
Primary practice location
1215 Kingsley Ave
Orange Park, FL 32073-4631
Mailing address
184 Vanderford Rd W
Orange Park, FL 32073-5900
Phone (904) 269-2812
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT 1839 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360022400000",
"number": "1689913188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "184 VANDERFORD RD W",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320735900",
"telephone_number": "904-269-2812"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1215 KINGSLEY AVE",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320734631",
"telephone_number": "904-269-8922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "GARY",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-05",
"last_updated": "2013-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 1839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.