Individual provider Active NPI

Kelli S Lewis, LPN

  • Licensed Practical Nurse
  • Cincinnati, OH
National Provider Identifier
1699089789
Registry record updated Aug 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN129053 Issued in OH
Practice address
2996 Wardall Ave
Apt 4
Cincinnati, OH 45211-4960
Phone
(513) 290-5492
NPI assigned
Jul 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN129053 OH Primary
Licensed Practical Nurse 164W00000X LPN081542 GA

Addresses

Primary practice location

2996 Wardall Ave
Apt 4
Cincinnati, OH 45211-4960

Mailing address

2996 Wardall Ave
Apt 4
Cincinnati, OH 45211-4960
Phone (513) 290-5492

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
LPN081542GAMDLicensed Practical Nurse
PN129053OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1280448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313539200000",
    "number": "1699089789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2996 WARDALL AVE",
            "address_2": "APT 4",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452114960",
            "telephone_number": "513-290-5492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2996 WARDALL AVE",
            "address_2": "APT 4",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452114960",
            "telephone_number": "513-290-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KELLI",
        "middle_name": "S",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-30",
        "last_updated": "2011-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN129053",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN081542",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2011; 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.