Chad Allan Lewis, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2012007269 Issued in MO

Practice address

4543 E Pearson Meadow Dr
Springfield, MO 65802-6242

Phone

(417) 350-3050

NPI assigned

Mar 13, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579219200000",
    "number": "1689949398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4543 E PEARSON MEADOW DR",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658026242",
            "telephone_number": "417-350-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4543 E PEARSON MEADOW DR",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658026242",
            "telephone_number": "417-350-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "CHAD",
        "middle_name": "ALLAN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-13",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2012007269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220024475",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "431767432",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen Michael Levine, DPM
• Andrew Charles Lewis, PHARM D
• Ann Lewis, CRNA
• Brad C Lewis, O.D.
• Brianna Nicole Lewis
• Cooper Lewis
• Debra A. Lewis, M.A., CCC-SLP
• Erin F Lewis, NP-C
• Ernest C Lewis, M.D.
• Katie Lynn Lewis, FNP

• Physician Assistant in Springfield, MO
• Providers in Springfield, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.