NPIMap

Individual provider Active NPI

William J Lewis, PAC

  • Physician Assistant
  • Galion, OH
National Provider Identifier
1699715722
Registry record updated Nov 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OH500020000 Issued in OH
Practice address
269 Portland Way S
Galion, OH 44833-2312
Phone
(419) 468-4841
Fax
(419) 462-0500
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X OH500020000 OH Primary
Emergency Medicine Physician 207P00000X 50.002000 OH

Addresses

Primary practice location

269 Portland Way S
Galion, OH 44833-2312

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050110000905 OH Practitioner - Physician Assistant 6204884828 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Professionals of Holmes County, Inc. 40 clinicians
Knox Community Hospital 117 clinicians

Practice addresses (Care Compare)

1261 Wooster Rd
Suite 200
Millersburg, OH 44654-1570
Phone (330) 674-3000

1330 Coshocton Ave
Mount Vernon, OH 43050-1440

1490 Coshocton
Suite B
Mount Vernon, OH 43050-6099
Phone (740) 393-9111

1490 Coshocton Ave
Mount Vernon, OH 43050-6099
Phone (740) 393-9111

Hospital & facility affiliations

  • Knox Community Hospital Hospital, Mount Vernon, OH, CCN 360040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.002000OHMDEmergency Medicine Physician
OH500020000OHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Knox Community Hospital CurrentSince Aug 31, 2012 Accepting new patients
Knox Community Hospital Current Accepting new patients
Knox Community Hospital Current Accepting new patients
Knox Community Hospital Current Accepting new patients
Samaritan Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Galion Emergency Physicians Inc Emergency Medicine Past Accepting new patients

Locations

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019

1490 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9111

1330 Coshocton Ave
Fl 5
Mount Vernon, OH 43050
Phone (740) 393-9040

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 1

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351728000000",
    "number": "1699715722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 PORTLAND WAY S",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448332312",
            "telephone_number": "419-468-4841",
            "fax_number": "419-462-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "OH500020000",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "50.002000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galion, OH

Sources for this page

Verify at the official NPI Registry.